학술논문

Refractive outcomes, corneal haze and endothelial cell loss after myopic photorefractive keratectomy in an Asian population: The Singapore Armed Forces' experience.
Document Type
Article
Source
Clinical & Experimental Ophthalmology. Jul2020, Vol. 48 Issue 5, p558-568. 11p.
Subject
*PHOTOREFRACTIVE keratectomy
*ASIANS
*ENDOTHELIAL cells
*HAZE
*CHINESE people
*MULTIVARIATE analysis
Language
ISSN
1442-6404
Abstract
Importance This study reports outcomes of myopic photorefractive keratectomy (PRK) in a mainly ethnic Chinese population in Singapore. Background: To assess the incidence and associations of corneal haze and endothelial cell count (ECC) loss up to 12 months after PRK. Design This was a retrospective case series conducted in a tertiary eye centre. Participants: A total of 158 patients (309 eyes) with a mean age of 22.1 ± 3.4 years were included. The majority was Chinese (97.4%) and male (97.4%). Mean preoperative spherical equivalent was −3.33 ± 1.15 D. Methods: Eyes were categorized based on postoperative haze severity. A multivariate analysis adjusting for age and use of intraoperative mitomycin‐C (MMC), preoperative sphere and cylinder was performed. Main outcome measures: Refractive outcomes and corneal haze 3 and 12 months after PRK were assessed. ECC measurements were obtained before PRK and at variable periods postoperatively. Results: At 12 months, overall efficacy index was 0.98, and safety index was 1.09. Eight (2.5%) eyes underwent enhancement surgery. An analysis was performed on 295 eyes that did not undergo enhancement and had complete clinical data, which demonstrated a decrease in the incidence of haze from 38.2% at 3 months to 9.3% at 12 months. Higher myopia was associated with increased haze severity at 3 months (OR, 1.36; P =.005). Higher astigmatism was associated with increased haze severity at 3 (OR, 1.65; P =.018) and 12 months (OR, 2.32; P =.015). Intraoperative MMC was not associated with haze severity or ECC loss. Conclusions and relevance: Myopia and astigmatism were associated with increased corneal haze severity. Intraoperative MMC did not accelerate ECC loss. Overall, PRK is effective, predictable and safe in Asian eyes. [ABSTRACT FROM AUTHOR]