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KEESUN TAE, Junggon Cho, Jiwon Hong, Soojeong Lee, Yebon eye research center; Cases review of Corneal opacification after photorefractive keratectomy (PRK).. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1526.
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To describe the postoperative results of 3 patients with various spectra of corneal opacification after PRK.
Three patients who had corneal opacification after PRK were reviewed
Case 1 The first patient, a 27-year-old woman, presented with severe pain and diffuse opacity on postoperative day 1 after PRK. After receiving intensive antibiotic treatment for the microbial infection of the cornea, pain was substantially alleviated. However the patient still had a wide area of persitent epithelial defect, with grade 4 corneal opacities persisting for more than three month in both eyes. The patient's best spectacle-corrected visual acuity (BSCVA)decresed gradually. We treated the patient with antibiotic eyedrops, autologous serum eyedrop and preservative free artificial tears. Six months after the PRK, we performed amniotic membrane transplantation (AMT) after removal of corneal epithelium and fibrous opacification materials on the surface of the cornea. Case 2 A 34-year-old woman, who underwent PRK surgery nine months ago, experienced thick corneal opacity with decreased BSCVA. Removal of the corneal opacifications was performed manually with a blade. In addition, 0.01% mitomycin-C was applied on the cornea for two minutes after removing opaque fibers. Two months after this treatment, the patients' visual acuity recovered to 20/20 without any occurrence of corneal haze. Case 3 The third patient, a 37-year-old high myopic male, had corneal opacity after undergoing enhancement PRK surgery. In the treatment of this patient, we decided to halt using topical steroid eyedrops in favor of clinical observation. Corneal opacification cleared spontaneously after four months, and visual acuity was restored to 20/20.
Corneal opacification after PRK usually results not only in decreased visual acuity, but also in decreased visual quality due to the photoactivation of some toxic substance in the eye. In some instances, microbial infection during epithelial healing may trigger the opacity. While in many cases it may take several months for the opacity to clear spontaneously after PRK, the prognosis is generally good. Nevertheless, in some cases, patients are left with significant refractive errors, in spite of treatment efforts. Further research to get more sophisticated understanding of corneal opacification followed by PRK is necessary, so that better treatment options may be available in the future.
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