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Sarah E. Eccles Brown, Charles D. Reilly, Vasudha A. Panday; Risk Factors For Corneal Haze Formation Following Surface Ablation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5743.
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To evaluate possible risk factors for corneal haze formation following surface ablation procedures including Fitzpatrick skin type, race/ethnicity, history of smoking, exposure to sandy/windy environments, average time spent outside during daylight hours and the percentage of that time spent with and without sunglasses.
The Joint Warfighter Refractive Surgery Center database was reviewed from Jan 2001 to Jan 2009 including 25,313 patients. Of these, 150 patients with greater than mild haze were identified. A matched control group without haze was created based on age, gender, treatment spherical equivalent, steroid amount and taper length. A telephone survey was conducted to gather information regarding the proposed possible risk factors. Inclusion criteria included active duty military receiving elective surgery during the specified time that were assigned to the haze or control group and elected to participate in the survey. Exclusion criteria included patients who elected to not participate in the survery, gross deviation from steroid taper, pregnant/nursing, use of MMC. The data was analyzed using logistic regression, chi square, two sample z test, and a Mann/Whitney test for p- values with SAS version 9.1.
Excellent visual outcomes were noted in both the haze and control groups. While there was little difference between the haze and control groups in the 6 month postop UCVA and BSCVA, the BSCVA Low Contrast is worse in the haze than the control group. Fitzpatrick skin type, race, smoking history, windy/sandy environment exposure, and average daily hours outside overall did not have any statistically significant differences between the haze and control groups. There was a statistically significant difference in the percent of time wearing sunglasses while outside, with the control group wearing protection 86.76% of the time compared to 78.11% in the haze group (p= 0.006).
Traditional risk factors for haze may be more important than race, smoking or environmental exposure. Higher use of sunglasses is correlated with a lower incidence of haze. Prospective studies should be performed to validate these results.
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