Prediction of corneal haze using an ablation depth/corneal thickness ratio after laser epithelial keratomileusis.
OBJECTIVE
To investigate the usefulness of ablation depth/corneal thickness (AD/CT) ratio to predict corneal haze after laser epithelial keratomileusis (LASEK) using a retrospective, comparative, interventional case series.


METHODS
Fifty patients (90 eyes; mean age 40.9 years) with myopia, hyperopia, and/or astigmatism underwent bilateral or unilateral LASEK for correction of refractive error. After epithelial flaps were created using an 18% alcohol solution, bilateral or unilateral LASEK was performed using the Alcon Autonomous LADARVision 4000 excimer laser. Visual acuity (best spectacle-corrected and uncorrected) and refractive error were measured before and after LASEK. Corneas were assessed by two independent evaluators under a slit-lamp biomicroscope with broad tangential illumination. The relative haze scale was quantitated: 0 (clear), 0.5+ (trace), 1+ (mild), 2+ (moderate), 3+ (marked), and 4+ (severe).


RESULTS
Mean preoperative spherical equivalent refraction was -5.46 +/- 3.74 D (range -12.375 to +5.00 D), mean ablation depth was 93.04 +/- 45.03 microm (range 21.2 to 207.2 microm), and mean AD/CT ratio was 0.18 +/- 0.09 (range 0.04 to 0.41). Of 90 eyes, 40 eyes had a higher ablation depth (AD/CT ratio > 0.18) and 50 eyes had a lower ablation depth (AD/CT ratio < 0.18); 92.5% of eyes in the higher ratio group developed clinically significant haze (1+ or greater). In the lower ratio group, 94% of eyes developed no more than 1+ corneal haze, if any.


CONCLUSIONS
The ablation depth/corneal thickness ratio is useful for predicting corneal haze after LASEK. An AD/CT ratio of 0.18 or more suggests that patients have a high risk of developing clinically significant haze (1+ or more) after LASEK.
Lin
Ning
N
Department of Ophthalmology and Visual Science, The University of Texas-Houston Medical School, Hermann Eye Center, Fannin St, Houston, TX 77030, USA.
Yee
Steven B
SB
Mitra
Shrabanee
S
Chuang
Alice Z
AZ
Yee
Richard W
RW
D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000601:surgery; D003315:Cornea / Q000473:pathology*; D003318:Corneal Opacity / Q000175:diagnosis*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000601:surgery; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps