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M. N. Welch, C. Reilly, R. L. Tarango, S. Larson, V. Panday, M. Caldwell; Smoking and Corneal Haze Following Refractive Surgery: Another Reason Not to Smoke!. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2859.
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Establish whether smoking increases the risk or severity of haze after refractive surgery. This information could be used to better counsel patients regarding behavior modification to improve surgical outcomes.
A retrospective review of 25, 313 refractive surgery patients was conducted to identify patients who developed corneal haze following refractive surgery: 157 patients were identified who developed greater than mild haze. These patients were matched for age, gender, race, refractive correction, length of steroid taper, amount of haze, number of treatments, and prophylactic use of Mitomycin C. Military electronic medical records were reviewed for all patients to determine tobacco dependency and were compared.
The Haze group consisted of 124 PRK, 32 LASEK, and 1 LASIK procedure. There were 130 males and 27 females. The average age was 31.9 years old (22-47). Both the haze and control groups demonstrated a 12.7% smoking prevalence. Prophylactic Mitomycin C was used on one patient who developed haze and no other patients received MMC. MSE treated was -4.7 D for all patients. Overall, there was an equal prevalence of smoking in the haze group and non-haze group; however, subgroup analysis demonstrated a nearly statistically significant (p = 0.07) trend of increased incidence of smoking in myopes above -5 D who developed haze.
Smoking demonstrates a strong trend to be an independent risk factor for the development of corneal haze in refractive surgery patients with -5 D of myopia or greater of treatment. It does not appear to be an independent risk factor for haze in those under -5 D.
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