Recurrence Rate After Phototherapeutic Keratectomy in Epithelial–Stromal TGFBI Corneal Dystrophies Compared With Epithelial Basement Membrane Dystrophy

Purpose: To compare the recurrence rate and functional outcome of epithelial–stromal TGFBI corneal dystrophies and epithelial basement membrane dystrophy (EBMD) after excimer laser phototherapeutic keratectomy (PTK). Methods: This single-center retrospective comparative study analyzed the rate of disease recurrence after PTK in a cohort of patients treated at the Department of Ophthalmology of the Saarland University Medical Center in Homburg/Saar between 2009 and 2024. The study included 63 eyes with epithelial–stromal TGFBI corneal dystrophies and 163 eyes with EBMD. Kaplan–Meier survival analysis was performed to assess the recurrence rate. Best-corrected visual acuity (BCVA), changes in refraction, astigmatism, and central corneal thickness before and after PTK were compared. Two-way analysis of variance (ANOVA) was used to examine the effects of time and type of diagnosis on the aforementioned parameters. Results: The recurrence rate after PTK in the TGFBI group was 52% with a mean time to recurrence of 3.0 ± 2.8 years. However, we found no differences among TGFBI dystrophies, which may be attributable, at least in part, to the limited sample size. In the EBMD group, 1.2% of eyes required a second PTK because of significant disease recurrence. Conclusions: PTK is an effective first-line surgical option for patients with anterior corneal disease, providing both functional and symptomatic improvements. Postoperative disease recurrence was significantly higher in TGFBI dystrophies than in EBMD. PTK can be safely repeated in patients with TGFBI-related corneal dystrophies who are likely to experience 1 or more disease recurrences over the course of their lifetime.