Management of late corneal haze following photorefractive keratectomy.
ABSTRACT Subepithelial corneal haze and myopic regression are potential complications following excimer photorefractive keratectomy (PRK). There are many medical and surgical methods of managing this haze. We present a 37-year-old male myope who underwent PRK and subsequently developed central corneal haze late in the postoperative course. The haze was managed initially with topical medications with limited success. Mechanical superficial keratectomy was done to remove the superficial scar tissue but the haze returned necessitating repeat excimer laser PRK, using a transepithelial technique. The haze did not recur. Both mechanical superficial keratectomy and repeat excimer laser ablation may ameliorate haze. Success of these procedures may depend on the morphology of the haze and the patient's individual wound healing response.
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ABSTRACT: To evaluate one-step topography-guided transepithelial ablation in the treatment of low to moderate myopic astigmatism using a 1KHz excimer laser. Retrospective study of 117 consecutive eyes available for evaluation 12 months after surgery. Pre- and post-operative visual and refractive data as well as post-operative pain and haze were analyzed. A novel technique integrating custom refractive- and epithelial- ablation in a single uninterrupted procedure was used. The mean pre-operative spherical equivalent (SE) and the mean cylinder were: -3.22 diopters (D) ±1.54 (SD) (range -0.63 to -7.25 D) and -0.77 D ±0.65 (range 0 to -4.50 D), respectively. At 12 months after surgery: no eyes lost ≥2 lines of corrected distant visual acuity (CDVA). Safety and efficacy indexes were 1.27 and 1.09, respectively. Uncorrected distant visual acuity (UDVA) was ≥20/20 in 96.6% of the eyes. Manifest refraction spherical equivalent was within ±0.5 D of the desired refraction in 93.2% of the eyes. Average root mean square (RMS) wavefront error measured at central 6 mm, increased from 0.38 pre-operatively to 0.47 µm post-operatively. Refractive stability was achieved and sustained 1 month after surgery. No visually significant haze was registered during the observation period. Post-operative pain was reported in 4.5% of patients. One-step transepithelial topography-guided treatment for low to moderate myopia and astigmatism performed with a 1 KHz laser, provided safe, effective, predictable and stable results with low pain and no visually significant haze.PLoS ONE 01/2013; 8(6):e66618. · 3.53 Impact Factor
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ABSTRACT: Cross-linking of corneal collagen (CXL) is a promising approach for the treatment of keratoconus and secondary ectasia. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze, permanent scars, endothelial damage, treatment failure, sterile infiltrates, and herpes reactivation are the other reported complications of this procedure. Cross-linking is a low-invasive procedure with low complication and failure rate but it may have direct or primary complications due to incorrect technique application or incorrect patient's inclusion and indirect or secondary complications related to therapeutic soft contact lens, patient's poor hygiene, and undiagnosed concomitant ocular surface diseases.Journal of Ophthalmology 01/2011; 2011:869015. · 1.37 Impact Factor
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ABSTRACT: We evaluate Spectral OCT (SOCT) with a speckle contrast reduction technique using resonant scanner for assessment of corneal surface changes after excimer laser photorefractive keratectomy (PRK) and we compare healing process between conventional PRK and transepithelial PRK. The measurements were performed before and after the surgery. Obtained results show that SOCT with a resonant scanner speckle contrast reduction is capable of providing information regarding the healing process after PRK. The main difference between the healing processes of PRK and TransPRK, assessed by SOCT, was the time to cover the stroma with epithelium, which was shorter in the TransPRK group.Biomedical Optics Express 04/2014; 5(4):1089-98. · 3.18 Impact Factor