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Epithelial healing and ocular discomfort after photorefractive keratectomy in children
Evelyn A Paysse1, M Bowes Hamill, Douglas D Koch
1Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA. epaysse@bcm.tmc.edu
Insights
Photorefractive keratectomy (PRK) in children resulted in rapid corneal epithelial healing within 3-5 days. Postoperative discomfort was minimal, with most pain subsiding after the second day.
Area of Science:
- Ophthalmology
- Pediatric eye care
- Refractive surgery
Background:
- Anisometropia and anisometropic amblyopia in children often require advanced treatment.
- Photorefractive keratectomy (PRK) is a surgical option for correcting refractive errors.
- Conventional therapies may be insufficient for severe cases of anisometropia.
Purpose of the Study:
- To evaluate the corneal epithelial defect healing rate after PRK in pediatric patients.
- To assess the level of postoperative discomfort experienced by children undergoing PRK.
Main Methods:
- Ten pediatric patients (ages 3-10) with severe anisometropia underwent PRK.
- Daily monitoring of corneal epithelial defect size until complete healing.
- Daily assessment of postoperative pain using a standardized scale.
Main Results:
- Complete corneal epithelial healing occurred by day 3 (60%) and day 4 (90%) in most patients.
- The mean healing time for the corneal epithelial defect was 3.5 days.
- Postoperative discomfort was mild on the first day and minimal by the second day, with no reported pain thereafter.
Conclusions:
- PRK leads to prompt healing of the corneal epithelial defect in children.
- The surgical procedure is associated with minimal postoperative discomfort in the pediatric population.
- PRK is a viable treatment option for pediatric anisometropia refractory to conventional therapies.
Objective:
To document the rate of healing of the corneal epithelial defect created by photorefractive keratectomy (PRK) and the degree of discomfort experienced by children treated with PRK.
Setting:
Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Methods:
Ten patients between 3 and 10 years of age were treated with PRK for severe anisometropia. All had anisometropic amblyopia refractory to conventional therapy with glasses or contact lenses and occlusion therapy. The size of the corneal epithelial defect was documented daily until the defect healed completely. Postoperative discomfort was documented daily using a pain-assessment scale until the epithelial defect healed completely.
Results:
Two children were treated with PRK for hyperopic anisometropia; the rest were treated for myopic anisometropia. Cumulatively, the corneal epithelium had healed completely by day 3 in 6 patients (60%), by day 4 in 9 patients (90%), and by day 5 in all patients. The mean healing time was 3.5 days. Patients experienced mild discomfort on the day of surgery and on the first postoperative day. They had minimal pain on day 2. After day 2, no patient reported pain or other discomfort.
Conclusions:
The corneal epithelial defect created by PRK healed promptly and was associated with minimal postoperative discomfort in children treated with the protocol described.
