OUTCOMES OF CORNEAL REFRACTIVE SURGERY IN PARIENTS WITH CORNEAL OPACITY

To evaluate the safety and efficacy of corneal refractive surgery in patients with corneal opacity and to determine the intraoperative and postoperative complications.

The study was conducted at R.P.Centre for Ophthalmic Sciences, AIIMS New Delhi, India.It is a prospective observational study conducted between May 2022 to September 2023. We recruited 20 eyes of 16 patients with mean age of 27 years. 75% of the patients were male and 25% female. 2 patients underwent SMILE and 18 underwent LASIK. 

20 eyes of 16 patients were recruited who underwent LASIK/SMILE for refractive correction of myopia or compound astigmatism ( 18 eyes LASIK, 2 eyes SMILE) in Zeiss Mel 90 platform by a single surgeon. UDVA( uncorrected distance visual acuity), BDVA( best corrected distance visual acuiyt), MRSE( mean refractive spherical equivalent), Pentacam parameters, densitometry values, level of opacity were analysed from baseline to 3 months follow up and intraoperative and postoperative complications were noted.

20 eyes with corneal opacity had a post operative UDVA of 0.00 logmar. Statistically significant fall in densitometry of all layers were noted at post operative 3 months follow up and clinical decrease in opacity was noted in few eyes. There were few intraoperative complications like opaque bubble layer (2 eyes), bleed during dissection( 1 eye), hinge tear( 1 eye), flap tear(1 eye), black spots ( 1 eye) however they did not alter the final visual outcome.

Patients with corneal opacity can successfully undergo corneal refractive surgeries like LASIK AND SMILE provided proper preoperative evaluation is done and careful surgical maneuvers are done to prevent complications. Our study reported 100% safety and efficacy.

The choice of surgery can be modified based on depth of opacity, hence removing the opacity along with refractive correction.

• For superficial opacities- PRK
• Deeper than 100 microns- LASIK
• Deeper than 120 microns- SMILE