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Corneal opacity after repeated photorefractive keratectomy
1Department of Ophthalmology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul #62, Yoido-dong, Younfdeungpo-ku, Seoul, 150-713, South Korea.
Journal of Cataract and Refractive Surgery
|August 8, 2001
Summary
Repeated photorefractive keratectomy (PRK) can lead to corneal opacity. This opacity is caused by deposits of specific collagen types and acidic mucoprotein in the extracellular matrix.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Tissue Engineering
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery.
- Repeated PRK procedures may increase the risk of complications.
- Corneal opacity is a potential, albeit rare, complication following refractive surgery.
Observation:
- A case of corneal opacity after five PRK procedures over three years is presented.
- Histopathological examination revealed epithelial thickening, subepithelial fibroblast proliferation, and absence of Bowman's membrane.
- Electron microscopy showed irregular collagen lamellae and electron-dense deposits.
Findings:
- Alcian blue staining indicated the presence of acidic mucoprotein.
- Immunohistochemistry confirmed the deposition of type IV and type VI collagen.
- These deposits were found in the extracellular matrix adjacent to keratocytes.
Implications:
- Repeated PRK may induce abnormal extracellular matrix deposition.
- Type IV and VI collagen, along with acidic mucoprotein, are implicated in post-PRK corneal opacity.
- Understanding these molecular changes can inform strategies to prevent or manage corneal opacity after refractive surgery.