Optical Coherence Tomography-Guided Transepithelial Phototherapeutic Keratectomy for Central Corneal Opacity in the Pediatric Population

Figure 2

Optical coherence tomography-guided transepithelial phototherapeutic keratectomy for central corneal opacity in the pediatric population. Corneal optical coherence tomography before and after phototherapeutic keratectomy. (a) Preoperative optical coherence tomography of the same 9-year-old female in Figure 1. Notice the central corneal opacity with adjacent irregularity of Bowman’s layer and epithelial compensation. A manual electronic caliper (red lines) measured the maximum depth of the corneal scar at 120 microns and total corneal pachymetry of 516 microns. Using this information, transepithelial phototherapeutic keratectomy calculations were made to treat to a target depth of 139 microns (which is expected to photoablate 91 microns of stroma after accounting for the measured baseline epithelial thickness of 48 microns) to preserve refractive neutrality. (b) Optical coherence tomography of the same patient from A 6 months after phototherapeutic keratectomy. After a predicted total stromal ablation depth of 91 microns, the central corneal opacity and irregularity in Bowman’s layer is totally resolved with complete restoration in the uniformity of the epithelium. Central corneal pachymetry is now 404 microns after reepithelialization and wound contraction.

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