Eyeworld

EW NEWS & OPINION 24 A lthough mitomycin C (MMC) has long been a sug- gested option for preventing corneal haze formation after PRK, new research suggests some ad- ditional tools and procedures could be helpful as well. The research, published online in October 2010 in Cornea, found that MMC used in conjunction with superficial keratectomy (SK) and ex- tended wear contact lenses (EWCLs) is particularly effective in reducing persistent corneal haze after PRK. "Most patients achieved UCVA of 20/40 or better," reported lead study author Hamid Khakshoor, M.D., Eye Research Center, Mashhad University of Medical Sciences, Iran. "The measured increase in BCVA was ≥3 lines in all eyes measured, with the exception of one. Additionally, all patients reported improvement of symptoms regarding optical aberra- tions." Previous research showed that after mechanical keratectomy with MMC, 38% of patients achieved UCVA of 20/30 or better, while in this study, 53% of eyes achieved the same. The addition of the EWCL may have had some benefit. "We think that using EWCL after SK may pro- vide a more even surface by remod- eling the corneal stroma, which leads to a reduction of corneal haze recurrence after SK," Dr. Khakshoor reported. New tactics for haze elimination Dr. Khakshoor analyzed 15 eyes of nine patients who underwent PRK for high myopia. Patients developed corneal haze and regression. SK was performed as late as 2 years after haze formation (in three patients). "Under topical anesthesia, mechanical removal of the corneal epithelium and stromal haziness was performed with a surgical blade (number 15) until complete smooth- ness and clearness of the underlying stroma were achieved," Dr. Khakshoor reported. "A sponge soaked with MMC (0.02%) was di- rectly applied over the exposed cornea for 1 minute." Afterward, both the cornea and conjunctival sac were irrigated with balanced salt solution. MMC was again used for 1 minute and then washed away. Topical steroids and antibiotics also were used. Finally, an EWCL was used for 1 month. Prior to SK, mean BCVA was 20/80 and ranged from 20/200 to 20/50. Corneal haze ranged from grade 2 to grade 4. Mean spherical equivalent was –3.91 +/–1.30, indi- cating significant regression. "The mean BCVA after treat- ment improved to 20/20 and ranged from 20/25–20/16," Dr. Khakshoor reported. "The mean spherical equivalent was changed to –0.85 +/– 1.19. Thirteen eyes (86.6%) achieved UCVA of at least 20/40." Corneal haze was significantly reduced, ranging from grade 0 to 0.5 post-op. "It was totally eliminated in 7 eyes (46.6%) and significantly re- duced in others," Dr. Khakshoor re- ported. Further, no patients had corneal haze recurrence during the follow- up period. Mean follow-up time was 12.11 +/–3.25 months. March 2011 by Matt Young EyeWorld Contributing Editor Research finds new tools and procedures can prevent corneal haze L A B S Ye s ! I Wo u l d L i ke To E va l u a t e A S a m p l e O f T h e F o l l ow i n g : T h e C o m p l e t e E A G L E O p h t h a l m i c P r o d u c t C a t a l o g N a m e A d d r e s s C i t y S t a t e Z i p P h o n e # C o n t a c t N a m e P l e a s e R e t u r n t o E a g l e , A t t e n t i o n : C u s t o m e r S e r v i c e FM 71198 10201-A TRADEMARK STREET, RANCHO CUCAMONGA, CA 91730-5850 USA Toll Free: 800 782-6534 Ph: 909 481-0011 • Fx: 909 481-4481 www.eaglelabs.com • email: goeagle@eaglelabs.com © Eagle Laboratories 2011 Stab Knives for Side Port or Scleral Incision 15, 22.5, 30, 45 degree Phaco Slit Knives for Clear Corneal or Scleral Incision 2.5, 2.65, 2.75, 2.85, 3.0, 3.2, 3.5 mm Short Stop 10L Inserter Knives for IOL Enlargement 3.5, 4.0, 5.2 mm Crescent Knives for Scleral Tunnel Incision 2.0 mm Spoon Knives for Scleral Tunnel Incision 3.0 mm MVR Knives for Vitreoretinal Infusion Port for Paracentesis Incision 19, 20, 23 GA Straight • 20, 23 GA Angled Clear Corneal Knives 2.75, 3.0, 3.2 mm Clear Corneal Knives, Parallel Sides 2.75, 3.0, 3.2 mm Trapezoid Clear Corneal / Implant Knives 2.85 - 3.2, 3.0 - 3.2 mm EW • Consistent Edge • Low Pricing • Total Customer Statisfaction gold ad 1/3 111.qxd 2/4/11 1:36 PM Page 1 An eye with haze Source: Parag A. Majmudar, M.D. Visit Us at ASCRS Booth 2313

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