1. Standard PRK vs. CustomVue: A Comparison of Haze
Vasudha A. Panday, Maj, USAF, MC
Charles D. Reilly, Lt Col, USAF, MC, FS
Wilford Hall Medical Center
Lackland AFB, TX

2. Background
Development of haze related to depth of ablation (refractive error)
Post ablation, keratocytes differentiate into myofibroblasts, cause stromal irregularity
Numerous factors affect myofibroblast transformation

3. Purpose
To compare the incidence of haze in post-refractive surgery patients in standard PRK versus wavefront guided PRK

4. Hypothesis
Wavefront-guided ablations will cause less stromal irregularity, leading to a decrease in corneal haze

5. Methods 12,551 eyes Retrospective analysis of myopic treatments
1, 3, 6, 12 months haze data
Haze graded on scale of 1-4
Eyes grouped by pre-op refractions:
< 4.00 D, 4.00 – 6.00 D, and > 6.00 D

6. Procedure Ablations performed with VISX S4 laser
6 – 6.5 mm optical zone with blend
Amoils brush to remove epithelium to 8mm
Irrigation with cold BSS immediately post ablation
BSCL applied
No prophylactic MMC

7. Post-operative Regimen
Flarex QID with 4 month taper
Ocuflox QID x 7 days
Tetracaine x 24 hours (“rescue” drop)
PO Percocet
BSCL removed day 4 or 7

8. Total Haze: < 4.00 D 1 Month 3 Months 6 Months 12 Months
Standard PRK
5.7%
(178/3132)
3.8%
(91/2374)
3.0%
(61/2037)
2.2%
(30/1374)
CustomVue
4.3%
(95/2217)
(35/1612)
0.9%
(10/1091) 0%
(0/536)
P = P = P = P =
* No haze was significant enough to require treatment

9. Total Haze: 4.00 D – 6.00 D 1 Month 3 Months 6 Months 12 Months
Standard PRK
6.6%
(271/4130)
4.6%
(142/3120)
5.6%
(150/2692)
3.7%
(68/1818)
CustomVue
4.5%
(125/2794)
2.6%
(53/2031)
1.5%
(21/1396)
0.3%
(2/683)
P = P = P = P =
* No haze was significant enough to require treatment

10. Total Haze: 4 – 6 D
* No haze was significant enough to require treatment

11. Total Haze: > 6.00 D 1 Month 3 Months 6 Months 12 Months
Standard PRK
10.3%
(20/194)
6.9%
(9/131)
25.8%
(32/124)
25.3%
(20/79)
CustomVue
5.3%
(4/76)
7.8%
(4/51)
15.0%
(6/40)
5.0%
(1/20)
P = P = P = P =
* No haze was significant enough to require treatment

12. Conclusions Less haze seen overall with CustomVue treatments
Most significant difference at each time point noted in < 6 D groups
Most likely due to decrease in stromal surface irregularities with wavefront-guided PRK compared to standard
With larger sample size, may see a significant decrease in haze in larger diopter treatments as well