Phototherapeutic Keratectomy Effective for Long-Term Symptom Relief from Bullous Keratopathy

Bullous Keratopathy
Bullous keratopathy, a pathological condition in which small vesicles, or “bullae,” are formed in the cornea due to endothelial dysfunction.
A majority of patients undergoing PTK did not experience complications or need additional procedures, according to a report.

Phototherapeutic keratectomy (PTK) is effective at providing symptomatic relief for patients who undergo bullous keratopathy, according to a study published in Cornea. 

Researchers conducted a retrospective analysis of 64 eyes of 64 patients who underwent PTK for symptomatic bullous keratopathy between June 2005 and March 2019, and had 12 months of follow-up or more (mean follow-up duration: 51 months, range: 12-140 months). They examined medical records for demographic data, etiology of bullous keratopathy, complication rates, and subsequent procedures following PTK. The study’s main outcome measurements were pain and recurrence of bullae, assessed at 3 time periods: 0 to 3 months, 4 to 12 months, and 12 months or more after PTK. 

Researchers found that the most common etiologies of this endothelial cell failure were complicated cataract surgery, trauma, and glaucoma (47%, 19%, and 17%, respectively). By 0 to 3 months, pain had resolved in 88% of eyes; between 3 and 12 months, it had resolved in 77% of eyes (P =.031, compared with 0-3 months); and it subsided in 70% after 12 months of follow up (P =.131, compared with 3-12 months). Recurrence rates were 17% of eyes within 0 to 3 months, 22% of eyes between 3 and 12 months (P <.001 compared with 0-3 months), and 33% of eyes after the 12-month follow-up (P <.001 compared with 3-12 months). Overall, 86% of participants who underwent PTK did not experience postoperative complications, and 74% did not need subsequent procedures.

Researchers are confident in the procedure’s ability to manage symptomatic manifestations of bullous keratopathy: “This study demonstrates that the use of PTK for the treatment of bullous keratopathy maintains effective long-term pain relief with minimal risk of complications.”

Study limitations include its retrospective nature and single center design. 


Hart CT, Cleary G, Chan E. Long-term outcomes of phototherapeutic keratectomy for bullous keratopathy. Cornea. 2022;41(2):155-158. doi:10.1097/ICO.0000000000002695