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A Journal on Ophthalmology
Minerva Oftalmologica 2005 March;47(1):43-58
Complications of excimer laser photorefractive keratectomy
Lamberti G., Campa C., Perri P., Costagliola C., Sebastiani A.
Excimer laser photorefractive keratectomy (PRK) was the first surgical laser procedure for the correction of refractive errors. The number of patients who have undergone PRK to eliminate glasses has progressively increased with years and many studies demonstrated safety and efficacy of this surgical technique. However, ophthalmologists must know the possible complications of PRK so that precautions can be taken to avoid them or, recognizing their early symptoms and signs, to treat them in the best way. This review offers a detailed description of PRK complications, dividing them into 2 sections: medical complications and optical complications. Medical complications include: discomfort and pain, delayed epithelial healing, recurrent corneal erosions, keratitis and sterile infiltrates, reactivation of herpes simplex keratitis, endothelial damage, haze, cataract, ptosis, anisocoria, iritis, retinal detachment, subretinal hemorrhages, cystoid macular edema, elevated intraocular pressure. Optical complications are: night vision disturbances (halos, glare), loss of contrast sensitivity, undercorrections, overcorrections, induced astigmatism, loss of visual acuity, decentration, central islands. In this review the incidence of each complication, pathogenetic mechanisms explaining its formation, related symptomatology and possible treatment modalities are evaluated.