Igor Kaiserman1, Naʼava Sadi, Michael Mimouni, Tzahi Sela, Gur Munzer, Shmuel Levartovsky. 1. *Department of Ophthalmology, Barzilai University Medical Center, Ashkelon, Israel; †Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel; ‡Care Vision Laser Centers, Tel Aviv, Israel; and §Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
Abstract
PURPOSE: To identify preoperative and intraoperative factors affecting breakthrough corneal haze incidence after photorefractive keratectomy (PRK) with mitomycin C (MMC). METHODS: In this retrospective study of PRK performed at the Care Vision Refractive Laser Center, Tel Aviv, Israel, a total of 7535 eyes (n = 3854 patients; mean age ± SD, 26 ± 6 years; 55% men) underwent PRK with intraoperative MMC application. Patients with histories of corneal pathology or surgery were excluded. Incidence, time of onset, and corneal haze severity were documented on follow-up of 118 ± 110 days. Eyes were grouped by preoperative refraction [low (≤-3D), moderate (-3D to -6D), or high (>-6D) myopia; low (≤3D) or high (>3D) astigmatism; low or high hyperopia]; by intraoperative time (above or below 40 seconds); and by MMC application time (above or below 40 seconds). The main outcome measures were incidence, onset time, and severity of corneal haze. RESULTS: The haze incidence was 2.1% in eyes with high myopia versus 1.1% in those with low to moderate myopia (P = 0.002), and 3.5 times higher in eyes with high than with low astigmatism (P < 0.05). The overall incidence was higher in eyes treated for hyperopia (10.8%) than for myopia (1.3%) (P = 0.0001). In eyes with moderate myopia, the haze incidence was lower in MMC application time ≥40 seconds (0%) than in <40 seconds (1.3%) (P = 0.03). After surgery, a mild early haze incidence peaked at 68.8 ± 6 days and severe late haze at 115 ± 17 days (P = 0.02). CONCLUSIONS: Hyperopic and large myopic or astigmatic corrections carry higher risk of haze. Longer MMC application might have beneficial haze prevention.
PURPOSE: To identify preoperative and intraoperative factors affecting breakthrough corneal haze incidence after photorefractive keratectomy (PRK) with mitomycin C (MMC). METHODS: In this retrospective study of PRK performed at the Care Vision Refractive Laser Center, Tel Aviv, Israel, a total of 7535 eyes (n = 3854 patients; mean age ± SD, 26 ± 6 years; 55% men) underwent PRK with intraoperative MMC application. Patients with histories of corneal pathology or surgery were excluded. Incidence, time of onset, and corneal haze severity were documented on follow-up of 118 ± 110 days. Eyes were grouped by preoperative refraction [low (≤-3D), moderate (-3D to -6D), or high (>-6D) myopia; low (≤3D) or high (>3D) astigmatism; low or high hyperopia]; by intraoperative time (above or below 40 seconds); and by MMC application time (above or below 40 seconds). The main outcome measures were incidence, onset time, and severity of corneal haze. RESULTS: The haze incidence was 2.1% in eyes with high myopia versus 1.1% in those with low to moderate myopia (P = 0.002), and 3.5 times higher in eyes with high than with low astigmatism (P < 0.05). The overall incidence was higher in eyes treated for hyperopia (10.8%) than for myopia (1.3%) (P = 0.0001). In eyes with moderate myopia, the haze incidence was lower in MMC application time ≥40 seconds (0%) than in <40 seconds (1.3%) (P = 0.03). After surgery, a mild early haze incidence peaked at 68.8 ± 6 days and severe late haze at 115 ± 17 days (P = 0.02). CONCLUSIONS: Hyperopic and large myopic or astigmatic corrections carry higher risk of haze. Longer MMC application might have beneficial haze prevention.
Authors: Rodrigo Carlos de Oliveira; Lycia Pedral Sampaio; Thomas Michael Shiju; Marcony R Santhiago; Steven E Wilson Journal: J Refract Surg Date: 2022-01-01 Impact factor: 3.573
Authors: Esther Arranz-Marquez; Andreas Katsanos; Vassilios P Kozobolis; Anastasios G P Konstas; Miguel A Teus Journal: Adv Ther Date: 2019-03-11 Impact factor: 3.845