Moshirfar Majid, Wang Qiancheng, Theis Joshua, Porter Kaiden C, Stoakes Isabella M, Payne Carter J, Hoopes Phillip C
Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St. #200, Draper, UT, 84020, USA.
John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
Ophthalmol Ther. 2023 Dec;12(6):2841-2862. doi: 10.1007/s40123-023-00782-1. Epub 2023 Aug 21.
Photorefractive keratectomy (PRK) is a safe and popular corneal surgery performed worldwide. Nevertheless, there is potential risk of corneal haze development after surgery. Proper management of post PRK haze is important for good visual outcome. We performed a comprehensive review of the literature on the various risk factors and treatments for PRK haze, searching the PubMed, Google Scholar, SCOPUS, ScienceDirect, and Embase databases using relevant search terms. All articles in English from August 1989 through April 2023 were reviewed for this study, among which 102 articles were chosen to be included in the study. Depending on the characteristics of and examination findings on post PRK haze, different management options may be preferred. In the proposed framework, management of PRK haze should include a full workup that includes patient's subjective complaints and loss of vision as well as visual acuity, biomicroscopy, anterior segment optical coherence tomography, epithelial mapping, and Scheimpflug densitometry. Topical steroid treatment for haze should be stratified based on early- or late-onset haze. Mechanical debridement or superficial phototherapeutic keratectomy (PTK) may be used to treat superficial corneal haze. Deep PTK and/or PRK can be used to treat deep corneal haze. Mitomycin-C and topical steroids are prophylactic post-surgery agents to prevent recurrence of haze.
准分子激光角膜切削术(PRK)是一种在全球范围内开展的安全且受欢迎的角膜手术。然而,术后存在角膜 haze 形成的潜在风险。妥善处理 PRK 术后 haze 对于良好的视觉效果至关重要。我们使用相关检索词在 PubMed、谷歌学术、SCOPUS、ScienceDirect 和 Embase 数据库中对关于 PRK haze 的各种风险因素和治疗方法的文献进行了全面综述。对 1989 年 8 月至 2023 年 4 月期间的所有英文文章进行了本研究的综述,其中 102 篇文章被选入本研究。根据 PRK 术后 haze 的特征和检查结果,可能会优先选择不同的处理方案。在所提出的框架中,PRK haze 的处理应包括全面检查,其中包括患者的主观症状、视力丧失以及视力、生物显微镜检查、眼前节光学相干断层扫描、上皮地形图和 Scheimpflug 密度测量。对于 haze 的局部类固醇治疗应根据早期或晚期发作的 haze 进行分层。机械清创或表层光动力角膜切削术(PTK)可用于治疗表层角膜 haze。深层 PTK 和/或 PRK 可用于治疗深层角膜 haze。丝裂霉素-C 和局部类固醇是预防术后 haze 复发的药物。