Photo-Therapeutic Keratectomy

PTK is a surgical procedure which is mainly used to treat scars on the cornea and any other type of corneal surface disease. These include corneal dystrophy and epithelial erosion syndrome.

1. What is ‘PTK?’
2. How does it differ from LASIK, LASEK and PRK?
3. Who should consider PTK?
4. If I am not suitable for PTK then is there an alternative?
5. What are the risks of PTK?
6. What are the benefits of PTK?
7. What should I ask the surgeon at the consultation?
8. How much does PTK cost?
9. Can I have this treatment on the NHS?
10. What is the PTK procedure?
11. How long do the effects of PTK last for?
12. What does recovery from PTK involve?

What is ‘PTK?’

PTK stands for Photo-Therapeutic Keratectomy: this surgery uses a laser to treat eyesight problems, which are mainly diseases of the surface of the cornea.

The aim of this procedure is to treat surface level corneal disease and NOT to remove the need to wear glasses or contact lenses.

However, this treatment can be combined with PRK which means that it has both a medical and cosmetic application.

How does it differ from LASIK, LASEK and PRK?

The main difference between PTK and these others is that it treats medical conditions such as corneal dystrophy. In other words, there is a clear medical need for this surgery.

LASIK, LASEK and PRK are performed to correct refractive errors, or for reasons of ‘personal enhancement’. In other words, they are undertaken for cosmetic reasons.

Refractive errors include myopia, hypermyopia/hyperopia, presbyopia and astigmatism.

Who should consider PTK?

PTK is suitable for patients with a disease or injury to the surface of their cornea. This includes corneal dystrophies such as granular dystrophy; scars on the cornea and a condition called ‘persistent epithelial erosion syndrome’.

If you are in good health and are looking to improve your current eyesight prescription then this is a good option. It is, however, important to remember that this does not guarantee perfect vision. You will still require glasses or contact lenses afterwards.

If you are looking for a procedure which can do this then consider PRK (which can be combined with PTK), LASIK or LASEK. The surgeon will be able to advise you about these procedures.

If I am not suitable for PTK then is there an alternative?

There are a couple of alternatives to PTK. These are a cornea transplant and manual scraping.

A cornea transplant is where the surgeon replaces the damaged part of the cornea (in the centre) with a clear, healthy cornea. This new cornea is obtained from a local eye bank. This procedure may be required to restore normal, focusing power to your eyes.

Cornea transplants are often referred to as PK – ‘Penetrating Keratoplasty’.

Manual or cornea scraping is the process in which the surgeon removes or scrapes away the damaged or diseased part of the cornea. For example, if a patient has a corneal ulcer.

What are the risks of PTK?

This is a safe and permanent procedure but like any form of surgery it does have a small amount of risk. These risks include glare, halos, starbursts and light sensitivity.

These are usually mild and tend to disappear over a period of time, although they can be permanent in a tiny number of cases.

The surgeon will discuss these with you during the consultation as well as assessing your suitability for PTK.

What are the benefits of PTK?

These include a smooth and transparent cornea and improved vision.

What should I ask the surgeon at the consultation?

The section titled ‘Laser Eye Surgery: General FAQS’ has a list of questions which you can use. These apply to all forms of eye surgery although you may want to include questions specific to this procedure.

For example:

• Can I combine this procedure with another which treats refractive errors, such as PRK?
• Can this procedure treat any form of corneal disease?
• What will my eyesight be like after this procedure?
• Will this mean a ‘lighter’ prescription (less severe)?

As with any procedure, it is a good idea to talk to a range of different surgeons and research this thoroughly before going ahead.

How much does PTK cost?

Costs vary between providers but PTK can cost around £900 per eye (average cost).

Can I have this treatment on the NHS?

The NHS will pay for treatments which they consider to be an essential ‘medical need’. In other words, there is likely to be noticeable physical, social and mental benefits from doing so.

If the NHS feels that there is a medical need then they may pay for treatment although this is not guaranteed.

It is worth talking to your GP as he or she can advise you further about this. If he/she feels that you have a strong case then he/she may be able to refer you to a suitable clinic.

If you have private medical insurance then check with your policy, and with your insurer. This along with laser eye surgery in general may be on their list of exclusions, but it is still worth checking.

What is the PTK procedure?

The area around your eye/s will be cleaned and anaesthetic drops will be placed in your eye/s to numb the area.

A special clip will be fastened to your eye/s to keep it/them open during the procedure.

The surgeon will remove the epithelium (outer layer of the cornea) to allow access for the laser. He/she will use an excimer laser to correct or reshape your cornea depending on the type of condition.

Antibiotic eye drops will be given post-surgery to prevent infection and a protective contact lens called a ‘bandage lens’ will be placed over the eye/s.

There will be some discomfort or pain whilst the epithelium heals although over the counter painkillers can control this.

How long do the effects of PTK last for?

The effects are permanent.

What does recovery from PTK involve?

This will involve taking things easy for a couple of days. Take a few days off work and use the antibiotic eye drops (and painkillers) to ease any pain or discomfort.

Don’t touch or rub your eye/s during this time. Wearing a plastic eye shield (similar to an eye patch) can help.

You will find that your eyesight is blurry or hazy for the first few days but this will settle down within a few days. It will be a week before you are able to drive.