A new study has found that Keratopigmentation (KTP) results in a significant decrease in subjective glare, photophobia, and monocular diplopia.
The minimally invasive procedure can be done with new micronised mineral pigments and new surgical techniques, making it possible to manage moderate to severe visual dysfunctions related to iris defects.
Jorge L. Alio, MD, PhD, professor and chairman of ophthalmology and the medical director of VISSUM Corporacion Oftalmologica in Alicente, Spain, and colleagues reported their experience with KTP in an article published online on July 27 and in the October print issue of the British Journal of Ophthalmology. They explain that, “[a]lthough several series using KTP for cosmetic purpose in blind eyes with leucomas have been reported, only a few clinical cases have been described concerning the use of KTP for correction of visual disability of the eye related to iris and pupil defects.”
Dr. Alio and colleagues describe the first use of femtosecond lasers for the purpose of KTP for visual functional disorders related to iris defects. They demonstrate that this new, less invasive KTP technique allows the surgeon to obtain adequate cosmetic and functional outcomes.
Dr. Alio and colleagues describe the first use of femtosecond lasers for the purpose of KTP for visual functional disorders related to iris defects
The study included 11 eyes of 11 patients (six women and five men; mean age, 37 years). Five patients had traumatic aniridia (either total or partial), two patients had traumatic coloboma, one patient had symptomatic peripheral iridectomy, one patient had atrophic and fixed dilated iris, one patient had severe iridocorneal endothelial syndrome with irregular pupil and polycordia, and one patient had intractable monocular diplopia.
Visual-function-related symptoms improved in all 11 eyes, with results ranging from significant improvement to total elimination. No patient lost any line of visual acuity. The authors reported that eight patients were asymptomatic after the surgery. Two patients were left with minimal non-disabling symptoms after surgery. One patient with traumatic aniridia had significant residual glare at the three month postoperative visit, and a second operation was performed to reduce the simulated pupil to 4mm.
Cosmetic outcomes were classified by an independent observer as excellent in eight patients and good in three patients. The patients evaluated their own cosmetic appearance as good to very good. None of the patients were considered to have poor or unacceptable aesthetic appearance.
Limitations include that the femtosecond laser is very expensive and is, therefore, not available in all ophthalmic hospitals.
