Risk factors for early-onset corneal haze after photorefractive keratectomy in an Asian population: Outcomes from the Singapore Armed Forces Corneal Refractive Surgery Programme 2006 to 2013

Abstract

Purpose: To assess the incidence and risk factors for early corneal haze after myopic photorefractive keratectomy (PRK).

Setting: Tertiary eye center, Singapore.

Design: Retrospective case series.

Methods: The refractive results and corneal haze severity 3 months after PRK were analyzed. Eyes were categorized into 4 groups based on haze severity. Multivariate ordinal logistic regression analysis adjusting for age, ethnicity, sex, use of intraoperative mitomycin-C (MMC), preoperative sphere, and preoperative cylinder was performed.

Results: The study reviewed data from 177 patients (347 eyes) with a mean age of 22.6 years ± 4.1 (SD). The majority of the patients were Chinese (98.3%) and men (98.3%). The mean preoperative spherical equivalent (SE) was -3.34 ± 1.19 diopters (D). One hundred thirty-five eyes (38.9%) had PRK with MMC. Ten eyes (2.9%) had enhancement surgery. The overall efficacy index was 0.88 and the safety index was 1.07. At 3 months, 187 eyes (53.9%) had no haze, 76 eyes (21.9%) had a haze grade of more than 0 and less than 1, 76 eyes (21.9%) had a haze grade of 1 or more and less than 2, and 8 eyes (2.3%) had grade 2 haze. Higher degrees of myopia (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.13-1.63; P = .001) and astigmatism (OR, 1.56; 95% CI, 1.09-2.24; P = .014) were associated with increased severity of corneal haze, whereas older age (OR, 0.94; 95% CI, 0.88-0.99; P = .023) had a protective effect.

Conclusion: Myopia and astigmatism were associated with increased severity of haze, and older age was protective against early corneal haze development after PRK in an Asian population.

Financial disclosure: None of the authors has a financial or proprietary interest in any material or method mentioned.