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 Post subject: Surgeons Identify New Postoperative Syndrome
PostPosted: Tue May 29, 2007 12:57 am 
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http://www.crstoday.com/Pages/News.php

Two refractive surgeons from Los Angeles have described a new syndrome that causes corneal opacification and hyperopic shift after LASIK and PRK. Their retrospective observational case series appears in the March 2007 issue of the American Journal of Ophthalmology.1

According to the investigators, central toxic keratopathy differs from other complications such as diffuse lamellar keratitis (DLK), acute infectious keratitis, and post-PRK haze in several ways. Although DLK preceded central toxic keratopathy in 18 of the 19 cases analyzed by the investigators (23 eyes of 14 patients), the subsequent corneal opacification they observed in the affected eyes was not inflammatory in nature and thus did not respond to treatment with topical steroids. The opacification was also limited to corneal tissue that was treated with excimer laser ablation, whereas they stated that DLK affects the flap's interface.

Other characteristics of central toxic keratopathy include an onset within 3 to 9 days after surgery, a hyperopic shift, and the spontaneous resolution of corneal opacity between 2 and 18 months postoperatively. In contrast, DLK usually appears on the first postoperative day, is not associated with a hyperopic shift, and requires medical intervention for resolution.

The exact cause of central toxic keratopathy is not known, but the investigators hypothesized that it is "a toxic reaction to some substance that undergoes photoactivation by the [excimer] laser." The hyperopic shift, they suggested, may "be related to keratocyte apoptosis, which may cause sufficient volume loss to collapse the central cornea."

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PostPosted: Sat Oct 06, 2007 3:48 pm 
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OCULAR SURGERY NEWS U.S. EDITION October 1, 2007

Post-laser refractive surgery complication identified in study

Quote:
Central toxic keratopathy, a syndrome characterized by noninflammatory central corneal opacification, can occur in some patients within 9 days after undergoing LASIK or PRK, according to a study.

Robert K. Maloney, MD, and Baris Sonmez, MD, reported results for 23 eyes of 14 patients who developed central toxic keratopathy in the immediate postoperative period after undergoing LASIK or PRK. All eyes had a central corneal opacification in the laser treatment area, and in 19 post-LASIK eyes, the opacification extended posteriorly into the stromal bed, the authors said.


Read the entire article at:
http://www.osnsupersite.com/view.asp?rID=24231

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