Preferred practice patterns for photorefractive keratectomy surgery

Abstract

Over the past two decades, excimer laser-based refractive surgery procedures have been successfully established for their safety and satisfactory visual outcomes. Surface ablation procedures or photorefractive keratectomy (PRK) are practised commonly for the correction of refractive errors including myopia, astigmatism and hyperopia. Satisfactory visual outcomes are achieved in majority of cases, although a very small percentage have issues related to corneal haze, regression, and its associated visual disturbances. To ensure optimal outcomes and to minimize complications, certain keys to success have been designed on the basis of the current review of literature on surface ablation procedures.

Keywords: Keys to success; PRK; preferred practice patterns.

Figure 1

Normal corneal wound healing post injury/surgery. Graph showing phase of activated keratocytes (a); corresponding in vivo confocal microscopy (IVCM) picture (d) Graph showing phase of myofibroblast and fibroblast (b); corresponding IVCM picture (e) Graph showing phase of apoptosis (c); corresponding IVCM picture (f)

Figure 2

Corneal wound healing post injury/surgery under abnormal conditions. Graph showing phase of excessive activated keratocytes (a); corresponding IVCM picture (c) Graph showing phase of excess myofibroblast, fibroblast and aberrant collagen formation (b); corresponding IVCM picture of the phase of excess myofibroblast and fibroblast (d); aberrant collagen formation (e)

Figure 3

Preparation of preservative-free ketorolac tromethamine 0.45% soaked BCL for pain management. Cleaning the outer surface of the contact lens packet with gauze piece soaked in 99.99% ethyl alcohol (a); injecting 0.2 ml preservative-free Ketorolac Tromethamine 0.45% into the contact lens solution using a tuberculin syringe (b); keeping the Ketorolac soaked contact lens in a sterile container for 20 minutes (c); placing the contact lens on the patient's eye at the end of the procedure (d)