Haze prevention following photorefractive keratectomy in brown eyes

Abstract

To study corneal haze following myopic photorefractive keratectomy (PRK) in a high-risk population and to assess methods for minimizing the risk. The medical records of 150 patients who underwent PRK were reviewed. A total of 300 eyes were included. All patients underwent myopic PRK using the Allegretto Wave Concerto 500Hz (Wavelight AG, Erlangen, Germany)excimer laser platform with intraoperative mitomycin-C (MMC) application. Demographic data including age, gender and ethnicity in addition to preoperative and postoperative subjective manifest refraction, spherical equivalent, best-corrected distance visual acuity, uncorrected distance visual acuity (UDVA), postoperative corneal haze grade and other possible postoperative complications were retrieved. Hanna grading (0-4+) was used to evaluate corneal haze. The patients were comprised of 74 men (49.3%) and 76 women (50.7%). The mean age at the time of surgery was 26.5±6.0 (range, 17-46) years. All patients were Saudis with brown irides. UDVA improved to 20/25 in 93.8% at 3 months. The mean and standard deviation of preoperative spherical equivalent was -3.02±1.63 (range, -7.63 - -0.13). At 3 months, postoperative spherical equivalent improved to 0.05±0.50 (-1.00 - +1.00). At 6 months, 13.6% exhibited corneal haze of grade 1, and none exhibited grades 2 or 3. The results of this study confirmed that patients with brown irides can achieve favorable outcomes after PRK. MMC, postoperative topical steroids and ultraviolet protection evidently play a major role in preventing corneal haze in high-risk populations.