A systematic algorithmic approach in photorefractive keratectomy (PRK) for optimal wound healing and outcomes
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First Author: P.Pandit INDIA
Co Author(s): R. Shetty A. Ghosh P. Khammar S. Sethu
To develop a Risk Scoring System (RSS) by thorough evaluation of potential risk factors in patients developing post-PRK corneal haze, and prophylactic management of these risk factors to mitigate post-operative haze.
Narayana Nethralaya Bengaluru India
Arm-1:To study the association between post-PRK corneal haze and risk factors (preoperative OSDI scores>30; contact lens intolerance; Meibomian gland dysfunction; low serum vitamin D and working environment).Retrospective analysis was done in 320 eyes of 160 PRK patients at 6 months and (RSS) was developed.Arm-2:RSS developed was used prospectively for 332 eyes of 166 eyes patients undergoing PRK.Based on their score, patients were divided into low, moderate and high-risk groups and their preoperative, intraoperative and post operatively management differed accordingly with respect to their dose and duration of steroid and anti-inflammatory drops.Post-operative assessment was done at 1,3 and 6 months.
Arm 1: 3.11% of PRK patients with high pre-operative risk score developed significant haze (grade 3 or more) at 6 months. Arm-2: a systematic Pre-operative management of these risk factors resulted in drop in incidence of corneal haze to 1.22 %.
Our novel Risk Scoring System and its application in management of risk factors may be a useful tool in preventing post-operative corneal haze thus, improving patient outcomes and in turn patient satisfaction.