Doctors especially, and those that have experienced haze,

I had prk done about 7 weeks ago on my eyes with MMC tx due to thin corneas. My prescription was around -9 bilateral. Used contact lens bandage for approx 2-3 days, terribly painful/with dryness when removed for several days. Used steroids/methylcellulose drops since procedure. I developed some moderate haze unilaterally only that was visible grossly at about 14-17 days out, after what appeared to be a period of delayed re-epithealization in the right eye. I've been using topical prednisolone steroids with some gross regression in the haze, using ocuvite high dose antioxidants vitamins, and now it must be virtually illuminated to see, but I have not noticed significant visual improvements from 20/50 or so. Other eye is perfect 20/20. Is there a timetable for the typical resolution of haze that will resolve. I have read articles that practically all haze resolves, but it can take as long as five years. I hope and pray this will disappear. I also am having difficulty with dry eye only at night and am hoping this will resolve in time.. I would appreciate any comments from experts in the field experienced with this complication on prognosis and potential possibilities.

Thanks very much.

Treatment of haze can take from weeks to months to respond. Topical steroids in most cases can lead to a resolution of post-surface ablation haze. Occasionally, a procedure called a PTK is required to remove residual haze that does not respond to treatment - but hopefully your case will respond. PTK is similar to the PRK procedure - except the laser is used to remove just the haze and not targeted to change a patients refractive error.
Of concern is your dry eye - which could be impeding the resolution of haze. I personally recommend punctal plugs and restasis in eyes with haze where dry eye is also an issue - since dry eye is inflammatory in nature.

I hope this helps

Bill trattler, MD
Miami, FL

I use very thick carboxymethylcelluose drops at night and I wake up with mild to moderate irritation that goes away within 10 minutes or so. Do you still believe this could be an issue in the haze resolution?

Thanks

You are describing dry eye - so you should ask your doctor for treatment - which will help your haze resolution (in my experience). I recommend punctal plugs and Restasis to help with haze resolution - as dry eyes can cause haze or prevent resolution of haze in my experience.

Best regards

Bill Trattler, MD
Miami, FL

Thanks for your suggestions. Could you describe any particular case reports you, or other physicians on this board have seen of this or any research out there that supports this. The feeling when I discussed this with the physician was that there was not any data to support that they were aware of.

In terms of update, I was able to get a punctal plug placed in the right eye a couple of weeks ago and have secured Dr. Holly's drops. Restasis was not felt to have any increased effects over steriods due to their similiar mechanisms of action. I have had little gross improvement in the last 6 weeks, but the doctor that saw me today said that it appeared to be a very thin area, on the surface that is somewhat offcenter. I was able to pinhole the center around the center to 20/25 vision. Of recent note, are nasty floaters that seemed to appear in this eye as well to add more insult. I know that they are common, but it sure is aggravating and hard to accept considering the relative proximity to vision enhancing surgery. I am steadfastedly praying for improving results as I know haze can take considerable time to improve. Thank you all for your support and comments.

JHC,

Floaters are common, particularly in someone like you who was very nearsighted. Still, the sudden onset of floaters is always a reason to have a thorough retinal examination. As nearsighted as you were, the peripheral retina is typically thinned, leaving it more susceptible to retinal tears and detachments. I would get it checked.

I've had it checked in the last few weeks by both an optometrist and my refractive surgeon. They seem to have a little trouble peering through the offcenter haze, but each has said that the retina appears healthy. The only thing left to do would be to see a retina specialist and obtain a bscan ultrasound with second opinion or just let it be. I'm in my twenties so it is unfortunately that I will just have to deal with it for a long time until scientific advances through research can find a safe way to remove the floaters, as there are no good txs now. Thanks, Appreciate your suggestion.
JHC

Appreciate the comments of all the doctor's. An RGP contact lens has proven to be successful as I have detailed in the other forum with similiar topic.

Thanks again

JHC

I always love to hear someone report a positive step, so I'm happy to know that an RGP lens has done the trick for you! Please keep us posted with your progress! Good luck.