<p>Main Complications of Photorefractive Keratectomy and their Management</p>

Abstract

Photorefractive keratectomy (PRK) was the first surface ablation procedure introduced for the treatment of refractive errors and has been proven to be effective and safe. In some cases, however, the patient may not be totally satisfied with the final result and retreatment may be necessary. We performed a literature review to describe the main conditions that may arise following PRK that may require retreatment and new promising techniques to allow customized and effective treatments for patients. There is currently no gold standard for retreatment of residual refractive error after PRK. The surgeon must take into account the patient’s history and type of problem when choosing the most appropriate technique. LASIK and PRK are the main options. Haze can be treated with good results with phototherapeutic keratectomy and mytomicin C. High order aberrations and decentration may be addressed with topographically-guided excimer photoablation or with wavefront-guided PRK.

<p>A Review on Different Tonometers for Intraocular Pressure Measurement After Photorefractive Keratectomy or Small Incision Lenticule Extraction</p>

“…Surgical treatment such as photorefractive keratectomy (PRK), laser assisted in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) can be used for correction. 3,4 Intraocular pressure (IOP) is one of the major risk factors for the development of glaucoma. 5 Therefore, it is important to measure the accurate intraocular pressure for screening or treatment of glaucoma.…”

Plasma rich in growth factors versus Mitomycin C in photorefractive keratectomy

“…The corneal haze is a significant complication that must be prevented and treated due to its high potential to generate a line of sight loss or higher complications. [ 3 , 14 ]…”

“…[ 9 , 19 – 21 ] It is essential to highlight that PRGF also has immunoregulatory and nerve regenerating properties, [ 11 , 20 , 22 , 23 ] with great potential to avoid the corneal haze formation in patients who underwent refractive surgeries. [ 3 ] Its effectiveness has also been demonstrated for the treatment of dry eye after LASIK. [ 24 ] In vivo studies carried out in animal models for PRK, it has been observed that PRGF increases the proliferation of corneal epithelial cells, and reduces the number of SMA positive cells (responsible for myofibroblast differentiation), which corresponds to greater corneal transparency for evaluation by microscopy.…”

“…[ 2 ] However, the corneal haze is a risk associated with the surgical procedure, which can lead to reduced visual quality and alterations in the refractive results, and it may be necessary to perform keratoplasties in severe cases. [ 3 ] This corneal opacity can generally appear within the first 12 weeks from the surgery; however, there are some cases of late appearance after 2 years. [ 4 ] Topical corticosteroids are used to resolve these corneal opacities in a few weeks; however, there are cases with no-resolution, generating discomfort and distress in the patient.…”

“…[ 4 ] Topical corticosteroids are used to resolve these corneal opacities in a few weeks; however, there are cases with no-resolution, generating discomfort and distress in the patient. [ 3 ]…”