Posters
Corneal opacification after refractive surgery with combined technique: photorefractive keratectomy (PRK) and accelerated cross-linking (PRK xtra)
Poster Details
First Author: I. Blanco Domínguez SPAIN
Co Author(s): F. Duch J. Reyes M. MartÃ
Abstract Details
Purpose:
To describe two clinical cases with corneal opacification after refractive surgery with combined technique: photorefractive keratectomy (PRK) and accelerated cross-linking (PRK xtra)
Setting:
The corneal haze after PRK is manifested as a bright layer of subepithelial deposits at the junction of the epithelium to the stroma. It starts a week after surgery, increasing to a peak between the first and third month, then it decreased slowly. The haze is usually clinically asymptomatic.
Methods:
The first case was a corneal opacification type corneal haze, paracentral and bilateral in deep stroma, debuted a month after treatment. The second case debuted 24 hours after surgery, in both eyes, with sterile infiltrates in the peripheral zone of the cornea. In both cases the surgery was a PRKxtra. Epithelial removal was made manually with spatula after a 20-second-application of 20% alcohol, and ablation was made with excimer laser WaveLight EX500, Alcon Surgical Inc. Later an accelerated crosslinking was made with the CCL Vario Illumination System according to the Peschkel L protocol, with a total energy of 2.70J/cm2.
Results:
In the first case decreasing doses of fluorometholone 0.25% eye drops and a moisturizing treatment were applied. One year after surgery a deep paracentral opacification type corneal haze was still presented, but it is less dense than in previous controls. The final UCVA was 0.8 / 0.9 (decimal scale).
In the second case a treatment with decreasing doses of prednisolone acetate eye drops 10mg / ml was made, with attenuation of the infiltrates, persisting at 3 months very tenuous peripheral scars. The final UCVA is 1.0 / 1.2 (decimal scale).
Conclusions:
A corneal opacification similar to subepithelial haze of PRK could be observed after crosslinking, it differed because the location could be extended in depth.It was generally paracentral and compatible with good visual results. Its peak occured a month, followed by a plateau phase of 3 months, to then start decreasing until after theyear.Sterile infiltrates in the corneal stroma occurred in 8% of the cases on the first day after crosslinking, they appeared especially in the periphery of the cornea.The presence of corneal opacities may occur exceptionally after PRK xtra treatment. The cases we had observed reached a good visual acuity.
Financial Disclosure:
NONE
