Corneal Breakthrough Haze After Photorefractive Keratectomy With Mitomycin C: Incidence and Risk Factors. Issue 8 (August 2017)

• Record Type: Journal Article
• Authors: Kaiserman, Igor; Sadi, Na'ava; Mimouni, Michael; Sela, Tzahi; Munzer, Gur; Levartovsky, Shmuel
• Is Part Of: Cornea. Volume 36:Issue 8(2017)
• Publication Date: 2017-08
• Subjects: cornea -- breakthrough -- haze -- photorefractive keratectomy -- mitomycin c -- MMC -- PRK; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000001231
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To identify preoperative and intraoperative factors affecting breakthrough corneal haze incidence after photorefractive keratectomy (PRK) with mitomycin C (MMC). Methods: In this retrospective study of PRK performed at the Care Vision Refractive Laser Center, Tel Aviv, Israel, a total of 7535 eyes (n = 3854 patients; mean age ± SD, 26 ± 6 years; 55% men) underwent PRK with intraoperative MMC application. Patients with histories of corneal pathology or surgery were excluded. Incidence, time of onset, and corneal haze severity were documented on follow-up of 118 ± 110 days. Eyes were grouped by preoperative refraction [low (⩽−3D), moderate (−3D to −6D), or high (>−6D) myopia; low (⩽3D) or high (>3D) astigmatism; low or high hyperopia]; by intraoperative time (above or below 40 seconds); and by MMC application time (above or below 40 seconds). The main outcome measures were incidence, onset time, and severity of corneal haze. Results: The haze incidence was 2.1% in eyes with high myopia versus 1.1% in those with low to moderate myopia ( P = 0.002), and 3.5 times higher in eyes with high than with low astigmatism ( P < 0.05). The overall incidence was higher in eyes treated for hyperopia (10.8%) than for myopia (1.3%) ( P = 0.0001). In eyes with moderate myopia, the haze incidence was lower in MMC application time ≥40 seconds (0%) than in <40 seconds (1.3%) ( P = 0.03). After surgery, a mild early haze incidence peaked at 68.8 ± 6 days and severe late haze at 115 ± 17 days ( P = 0.02). Conclusions: Hyperopic and large myopic or astigmatic corrections carry higher risk of haze. Longer MMC application might have beneficial haze prevention.