Atighehchian Mehrnaz, Alipour Fateme, Ghanbari Hamidreza, Abdolalizadeh Parya, Hashemian Hesam
Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Int Ophthalmol. 2025 Aug 28;45(1):360. doi: 10.1007/s10792-025-03712-1.
To assess the incidence rate of corneal haze after combined simultaneous photorefractive keratectomy (PRK) and accelerated (10-min, 9 mW/cm) corneal cross-linking (CXL) for non-keratoconus.
This is a retrospective cohort study on patients without keratoconus underwent simultaneous CXL-PRK. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, corneal keratometry, and corneal haze were evaluated.
Included were 92 eyes of 55 subjects with mean age of 31.42 ± 4.62 years and mean follow-up time of 13.83 ± 11.24 months (range: 6 to 46 months). Mean UCVA improved significantly from 1.06 ± 0.36 to 0.14 ± 0.17 logMAR after procedure (P = 0.01), but the mean BCVA worsened significantly from 0.02 ± 0.05 to 0.08 ± 0.11 logMAR (P = 0.01). Significant corneal haze occurred in 18 eyes (19.6%). Among them 11 eyes (61.1%) developed corneal haze in first postoperative year. The BCVA deteriorated in 83.3% (15/18) of hazy eyes while 63.5% (47.74) of eyes without haze formation did not have any change of BCVA (P < 0.001). The UCVA improved in majority of eyes with (88.9%, 16/18) or without (97.3%, 72/74) haze formation (P = 0.18). Densitometry analysis showed that the densest layer of cornea in eyes with haze was anterior layer at 10-12 periphery zone followed by anterior layer at 2 mm central zone.
Nearly one-fifth of eyes develops significant corneal haze after CXL-PRK procedure. Despite of UCVA improvement, the loss of BCVA in eyes with corneal haze, suggests that CXL-PRK procedure should be approached with caution.
评估在非圆锥角膜患者中，联合进行准分子激光原位角膜磨镶术（PRK）和加速（10分钟，9毫瓦/平方厘米）角膜交联术（CXL）后角膜 haze 的发生率。
这是一项对接受同步CXL-PRK的非圆锥角膜患者的回顾性队列研究。评估了未矫正视力（UCVA）、最佳矫正视力（BCVA）、明显验光、角膜曲率测量和角膜 haze。
纳入了55名受试者的92只眼，平均年龄为31.42±4.62岁，平均随访时间为13.83±11.24个月（范围：6至46个月）。术后平均UCVA从1.06±0.36显著提高到0.14±0.17 logMAR（P = 0.01），但平均BCVA从0.02±0.05显著恶化到0.08±0.11 logMAR（P = 0.01）。18只眼（19.6%）出现明显的角膜 haze。其中11只眼（61.1%）在术后第一年出现角膜 haze。有 haze 的眼中83.3%（15/18）的BCVA恶化，而无 haze 形成的眼中63.5%（47/74）的BCVA没有任何变化（P < 0.001）。大多数有（88.9%，16/18）或无（97.3%，72/74）haze 形成的眼的UCVA得到改善（P = 0.18）。密度测量分析表明，有 haze 的眼中角膜最致密层是周边10-12区域的前层，其次是中央2毫米区域的前层。
在CXL-PRK手术后，近五分之一的眼会出现明显的角膜 haze。尽管UCVA有所改善，但有角膜 haze 的眼中BCVA的丧失表明，CXL-PRK手术应谨慎进行。
