Markan Ashish, Chabbra Shivani, Asif Mohammed Ibrahime, Chaudhary Rahil, Tripathi Manasi
Eye7 Chaudhary Eye Hospitals, New Delhi, India.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS New Delhi, India.
Rom J Ophthalmol. 2025 Jan-Mar;69(1):48-52. doi: 10.22336/rjo.2025.09.
To report demographic profile and clinical characteristics of acute anterior uveitis (AAU) after Photorefractive Keratectomy (PRK).
This retrospective study reviewed records of all patients who underwent PRK to correct ametropia between July 2021 and June 2023. Patients who developed postoperative AAU were included for evaluation. Demographic details, preoperative ocular examination, intraoperative details, postoperative examination, time to onset of AAU, grading of cells, flare and pigments, time to heal, and final visual outcome were analyzed.
Records of 390 patients who underwent PRK during the study period were reviewed. Of these, 16 (29 eyes, b/l:13 patients, u/l: 3 patients) presented with AAU following PRK. The mean age of patients was 27.43 + 4.53 years (range 22-32 years), with a mean spherical equivalent of -3.18 + 2.16 (range -2 to -7 D). Mean ablation depth was 55.13 + 28.10 mm (range 27-105 mm), and mean duration of excimer laser ablation was 11.27 + 8.31 seconds (range 3-36 seconds). The mean onset time of AAU post-surgery was 27.8 + 10.9 days (range 7-47 days). Most eyes (75.86%, n=22) had a moderate-intense grade of inflammation, while 82.75% (n=24) of the eyes had significant pigment dispersion. The mean healing time was 57.43 + 27.87 days (33-106 days). The median follow-up duration was 12 months (range 6-18 months). The incidence of AAU post-PRK in our study was 4.1%.
This study's incidence of post-PRK acute anterior uveitis (AAU) was 4.1%, aligning with previous reports of rare but significant inflammatory responses following PRK. The mean onset at 27.8 days suggested a delayed immune-mediated reaction rather than an immediate post-surgical response. While most cases had mild-to-moderate inflammation, a subset experienced severe reactions and ocular hypertension, reinforcing the need for close monitoring. The absence of systemic associations and posterior segment involvement suggested the role of a localized immune response. Despite the prolonged resolution time, all eyes achieved a final CDVA of 0 LogMAR, indicating favorable long-term outcomes with timely intervention and management.
Anterior uveitis following PRK is infrequent. While it presents with marked anterior chamber reaction and pigment dispersion, the inflammation is often well-controlled with topical steroids. It does not affect the final visual outcome.
报告准分子激光原位角膜磨镶术（PRK）后急性前葡萄膜炎（AAU）的人口统计学特征和临床特征。
这项回顾性研究回顾了2021年7月至2023年6月期间所有接受PRK矫正屈光不正的患者的记录。纳入发生术后AAU的患者进行评估。分析人口统计学细节、术前眼部检查、术中细节、术后检查、AAU发病时间、细胞分级、房水闪辉和色素沉着、愈合时间以及最终视力结果。
回顾了研究期间390例接受PRK的患者的记录。其中，16例（29只眼，双眼：13例患者，单眼：3例患者）在PRK后出现AAU。患者的平均年龄为27.43±4.53岁（范围22 - 32岁），平均等效球镜为-3.18±2.16（范围-2至-7 D）。平均消融深度为55.13±28.10 mm（范围27 - 105 mm），准分子激光消融的平均持续时间为11.27±8.31秒（范围3 - 36秒）。术后AAU的平均发病时间为27.8±10.9天（范围7 - 47天）。大多数眼睛（75.86%，n = 22）有中度至重度炎症，而82.75%（n = 24）的眼睛有明显的色素播散。平均愈合时间为57.43±27.87天（33 - 106天）。中位随访时间为12个月（范围6 - 18个月）。我们研究中PRK后AAU的发生率为4.1%。
本研究中PRK后急性前葡萄膜炎（AAU）的发生率为4.1%，与先前关于PRK后罕见但显著的炎症反应的报道一致。平均发病时间为27.8天，提示为延迟的免疫介导反应而非术后即刻反应。虽然大多数病例有轻度至中度炎症，但一部分患者经历了严重反应和高眼压，这进一步强调了密切监测的必要性。无全身关联和后段受累提示为局部免疫反应的作用。尽管愈合时间延长，但所有眼睛最终的最佳矫正视力（CDVA）均达到0 LogMAR，表明及时干预和管理可带来良好长期结果。
PRK后前葡萄膜炎并不常见。虽然它表现为明显的前房反应和色素播散，但炎症通常可通过局部使用类固醇得到良好控制。它不影响最终视力结果。
