Corneal Breakthrough Haze After Photorefractive Keratectomy With Mitomycin C: Incidence and Risk Factors

Abstract

Hyperopic and large myopic or astigmatic corrections carry higher risk of haze. Longer MMC application might have beneficial haze prevention.

Three-year outcomes after high hyperopia correction using photorefractive keratectomy with a large ablation zone

“…After surface ablation, up to 52% of eyes develop some degree of corneal haze in the first months, with values most often reported within the range of 5%–20% 18. The overall incidence of haze is higher in eyes treated for hyperopia than for myopia 19. Wagh et al reported a 40% incidence of remnants of the haze ring still evident 18 years after hyperopic PRK, but MMC was not used when the procedures were performed 4.…”

“…Second, chilled balanced salt solution was used throughout the surgery. Population-based factors specific to our cohort (comprising adults living in Central Europe), such as relatively low ultraviolet light exposure, may also play a role 19. Finally, the modern excimer laser used in the study could also be an influencing factor, as the final 20% of ablation was performed with a low energy fluence, potentially providing smoother ablation surfaces.…”

Comparison of Higher-Order Aberrations After Single-Step Transepithelial and Conventional Alcohol-Assisted Photorefractive Keratectomy

“…For example, the risk of corneal haze increases 2 fold in subjects with more than 6 D myopia. 9 This should be considered an important limitation, and more homogeneous groups of patients in a narrower age range and separated into groups of low, moderate, or high myopia would be able to refine the results and overcome this limitation. Epithelial healing (re-epithelialization) processes and subjective visual parameters (pain, photophobia, photic phenomena, etc.)…”

“…Mitomycin C 0.02% was applied for 30 seconds in eyes with SE greater than 3 D and for 60 seconds if greater than 6 D due to increased risk of corneal haze. 9 After laser ablation, a bandage contact lens (Senofilcon A [Acuvue Oasys, J&J, Vision Care, Inc., Jacksonville, FL]) was applied for 5 days. Postoperative topical moxifloxacin 0.5% (Vigamox, Alcon, Fort Worth, TX) 3 times a day for 1 week, topical dexamethasone (Maxidex, Alcon, Fort Worth, TX) starting after epithelial healing and tapered off over 3 weeks and artificial tears every 2 hours for 2 months were prescribed.…”

Photorefraktive Keratektomie (PRK) zur Korrektur der Restfehlsichtigkeit nach radiärer Keratotomie

“…Über die Dauer der Mitomycin-C-Applikation existiert keine einheitliche Empfehlung, wir haben uns in dieser Studie für eine relativ kurzzeitige Applikationzeit (30 s) entschieden. Eine Korrelation der Haze-Wahrscheinlichkeit mit der Applikationsdauer von Mitomycin C ist beschrieben [11]. Andererseits führt eine verlängerte Mitomycin-C-Applikationsdauer auch zum Übertritt des Wirkstoffes ins Kammerwasser und könnte endothelschädigend wirken [12].…”