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Moshirfar M, Wang Q, Theis J, Porter KC, Stoakes IM, Payne CJ, Hoopes PC. Management of Corneal Haze After Photorefractive Keratectomy. Ophthalmol Ther 2023; 12:2841-2862. [PMID: 37603162 PMCID: PMC10640498 DOI: 10.1007/s40123-023-00782-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023] Open
Abstract
Photorefractive keratectomy (PRK) is a safe and popular corneal surgery performed worldwide. Nevertheless, there is potential risk of corneal haze development after surgery. Proper management of post PRK haze is important for good visual outcome. We performed a comprehensive review of the literature on the various risk factors and treatments for PRK haze, searching the PubMed, Google Scholar, SCOPUS, ScienceDirect, and Embase databases using relevant search terms. All articles in English from August 1989 through April 2023 were reviewed for this study, among which 102 articles were chosen to be included in the study. Depending on the characteristics of and examination findings on post PRK haze, different management options may be preferred. In the proposed framework, management of PRK haze should include a full workup that includes patient's subjective complaints and loss of vision as well as visual acuity, biomicroscopy, anterior segment optical coherence tomography, epithelial mapping, and Scheimpflug densitometry. Topical steroid treatment for haze should be stratified based on early- or late-onset haze. Mechanical debridement or superficial phototherapeutic keratectomy (PTK) may be used to treat superficial corneal haze. Deep PTK and/or PRK can be used to treat deep corneal haze. Mitomycin-C and topical steroids are prophylactic post-surgery agents to prevent recurrence of haze.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St. #200, Draper, UT, 84020, USA.
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
- Utah Lions Eye Bank, Murray, UT, 84107, USA.
| | | | - Joshua Theis
- University of Arizona College of Medicine-Phoenix, Phoenix, AZ, 85004, USA
| | - Kaiden C Porter
- University of Arizona College of Medicine-Phoenix, Phoenix, AZ, 85004, USA
| | - Isabella M Stoakes
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St. #200, Draper, UT, 84020, USA
- Pacific Northwest University of Health Sciences, Yakima, WA, 98901, USA
| | - Carter J Payne
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St. #200, Draper, UT, 84020, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Phillip C Hoopes
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St. #200, Draper, UT, 84020, USA
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