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D. A. Silvera, M. J. Fabrizio, K. M. Goins; The Characterization of Interface Haze Following DLEK. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4715.
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To characterize interface haze following DLEK including onset and change over the first year post-operatively.
We examined 7 cases of interface haze (IH) through chart and operative note review, BSCVA, corneal densitometry measures using Pentacam, confocal biomicroscopy data, and 3-D reconstructions of confocal images using a new software, Analyze 7.0. Corneal densitometry was measured at 180 degrees for comparison and reported peak anterior density (due to subepithelial fibrosis/bullous changes) and posterior density (interface). The mean and range of onset of IH was recorded.
Of the 82 DLEK procedures, 8 were found to have clinically significant interface haze. Seven of the 8 cases had data available for analysis. The mean onset of IH was 14.4 days with a range of 1 to 37 days. From 1-3 months post-op, 57% of cases had their highest peak densities in the posterior cornea (i.e. at the interface). At 6 months, this number was still 50%. However, at 1 year, 100% of the highest peak densities were anterior. BSCVA in the IH group lagged behind the group without IH at 1 month (20/80 vs 20/53), at 3 months (20/59 vs 20/45), and at 6 months (20/49 vs 20/37). However, at 1 year the IH group had the same BSCVA as the group without IH (20/38 vs 20/39).
In all cases, the last data point for peak corneal density occurred in the anterior cornea, likely representing pre-operative subepithelial fibrosis since these numbers did not change much over time. The recovery of BSCVA for the IH group trailed behind the group without IH for up to 6 months post-op. However, both groups had comparable BSCVA at 1 year. This correlates with the Pentacam densitometry data that demonstrated that maximal resolution of IH occurs between 6 months and 1 year. The visual prognosis at 1 year appears to be minimally affected by the occurrence of IH but rather the amount of permanent anterior corneal changes present pre-operatively.
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