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Standard PRK vs. CustomVue: A Comparison of Haze

Standard PRK vs. CustomVue: A Comparison of Haze. Vasudha A. Panday, Maj, USAF, MC Charles D. Reilly, Lt Col, USAF, MC, FS Wilford Hall Medical Center Lackland AFB, TX. Background. Development of haze related to depth of ablation (refractive error)

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Standard PRK vs. CustomVue: A Comparison of Haze

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  1. Standard PRK vs. CustomVue: A Comparison of Haze Vasudha A. Panday, Maj, USAF, MC Charles D. Reilly, Lt Col, USAF, MC, FS Wilford Hall Medical Center Lackland AFB, TX

  2. Background • Development of haze related to depth of ablation (refractive error) • Post ablation, keratocytes differentiate into myofibroblasts, cause stromal irregularity • Numerous factors affect myofibroblast transformation

  3. Purpose • To compare the incidence of haze in post-refractive surgery patients in standard PRK versus wavefront guided PRK

  4. Hypothesis • Wavefront-guided ablations will cause less stromal irregularity, leading to a decrease in corneal haze

  5. Methods • 12,551 eyes • Retrospective analysis of myopic treatments • 1, 3, 6, 12 months haze data • Haze graded on scale of 1-4 • Eyes grouped by pre-op refractions: < 4.00 D, 4.00 – 6.00 D, and > 6.00 D

  6. Procedure • Ablations performed with VISX S4 laser • 6 – 6.5 mm optical zone with blend • Amoils brush to remove epithelium to 8mm • Irrigation with cold BSS immediately post ablation • BSCL applied • No prophylactic MMC

  7. Post-operative Regimen • Flarex QID with 4 month taper • Ocuflox QID x 7 days • Tetracaine x 24 hours (“rescue” drop) • PO Percocet • BSCL removed day 4 or 7

  8. Total Haze: < 4.00 D P = 0.0231 P = 0.0031 P = 0.0001 P = 0.0001 * No haze was significant enough to require treatment

  9. Total Haze: 4.00 D – 6.00 D P = 0.0002 P = 0.0003 P = 0.0001 P = 0.0001 * No haze was significant enough to require treatment

  10. Total Haze: 4 – 6 D * No haze was significant enough to require treatment

  11. Total Haze: > 6.00 D P = 0.2389 P = 0.7587 P = 0.1984 P = 0.0646 * No haze was significant enough to require treatment

  12. Conclusions • Less haze seen overall with CustomVue treatments • Most significant difference at each time point noted in < 6 D groups • Most likely due to decrease in stromal surface irregularities with wavefront-guidedPRK compared to standard • With larger sample size, may see a significant decrease in haze in larger diopter treatments as well

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