Management of Corneal Haze After Photorefractive Keratectomy

Moshirfar, Majid; Wang, Qiancheng; Theis, Joshua; Porter, Kaiden C.; Stoakes, Isabella M.; Payne, Carter J.; Hoopes, Phillip C.

doi:10.1007/s40123-023-00782-1

Cited by 8 publications

(1 citation statement)

References 98 publications

(146 reference statements)

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“…Higher ablation depths, often associated with certain procedures like LASIK, pose an increased risk. Studies elucidate that the use of LASIK over surface ablation techniques amplifies the likelihood of postoperative dry eye symptoms [ 80 ]. Moreover, corneal characteristics such as flattened corneas and lower tear meniscus heights serve as additional risk indicators, contributing to the overall predisposition of patients to develop dry eye post-surgery [ 81 ].…”

Section: Reviewmentioning

confidence: 99%

Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Dossari

2024

Cureus

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Dry eye disease frequently manifests following corneal refractive procedures, significantly impacting patients' quality of life. This review systematically synthesizes current evidence on the pathophysiological mechanisms, risk factors, and therapeutic interventions for post-refractive surgery dry eye. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of literature published until August 2023 was conducted, focusing on post-refractive surgery dry eye. Eighteen relevant studies were identified through screening and eligibility assessment. A qualitative synthesis of outcomes was performed using narrative and thematic analysis methods. Surgically induced neurotrophic deficiency, stemming from nerve transection, triggers a cascade of events including apoptosis, inflammation, and lacrimal dysfunction, ultimately leading to tear film instability. Risk factors such as female gender, thyroid eye disease, meibomian gland dysfunction, higher ablation depths, and the use of LASIK over surface ablation exacerbate the condition. While conventional treatments like artificial tears provide temporary relief, emerging interventions such as nerve growth factors, matrix metalloproteinase inhibitors, serum eye drops, and specialized contact lenses show promise in promoting nerve regeneration and epithelial healing. Strategies such as customized ablation profiles, smaller optical zones, and nervesparing techniques like small incision lenticule extraction demonstrate potential advantages. A multifaceted therapeutic approach targeting neuroprotection, anti-inflammatory mechanisms, and tear film stabilization is imperative for effectively managing post-refractive surgery dry eye. Future research should focus on evaluating prognostic biomarkers, exploring precision medicine approaches, and investigating neuroprotective adjuvants to further enhance treatment outcomes.

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Section: Reviewmentioning

confidence: 99%

Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Dossari

2024

Cureus

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Topical losartan ophthalmic drops – a review of corneal wound healing and topical losartan for managing corneal haze and potential future indications

Abdelghaffar,

Güell,

Moura-Coelho

2024

Graefes Arch Clin Exp Ophthalmol

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Corneal Refractive Surgery Considerations in Patients With History of Orthokeratology

Wang,

Moin,

Hoopes

et al. 2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objective: To review the current literature describing corneal changes observed with orthokeratology (ortho-k) use and to formulate preliminary recommendations for these patients seeking corneal refractive surgery. Methods: The literature search was conducted through the PubMed, Scopus, and Ovid databases through June 4, 2024, for articles regarding corneal physiological, tomographic, and biomechanical changes secondary to ortho-k use. Results: Forty-one articles were found describing several changes associated with ortho-k use, including higher corneal staining, central corneal epithelial thinning and midperipheral thickening, increased higher-order aberrations, decreased contrast sensitivity, reduced corneal hysteresis and corneal resistance factor, and alterations in the tear proteome. The majority of these parameters returned to baseline after ortho-k lens discontinuation, with timing potentially dependent on the amount of myopic correction, duration of ortho-k use, and age of lens fitting. Conclusions: Despite the paucity of articles describing prior ortho-k patients undergoing corneal refractive surgery, it is evident that ortho-k use may potentially cause various corneal physiological, tomographic, and biomechanical changes in patients. Therefore, clinicians are advised to serially monitor ortho-k patients' refraction, tomography, pachymetry, and corneal biomechanics until stability is achieved before considering surgery.

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Management of Corneal Haze After Photorefractive Keratectomy

Cited by 8 publications

References 98 publications

Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Topical losartan ophthalmic drops – a review of corneal wound healing and topical losartan for managing corneal haze and potential future indications

Corneal Refractive Surgery Considerations in Patients With History of Orthokeratology

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