Corneal subepithelial infiltrates following excimer laser photorefractive keratectomy

Corneal subepithelial opacification associated with pain, photophobia, and injection has been reported in the first to third day following photorefractive keratectomy (PRK). Regardless of treatment, the resolution has generally left the patient with permanent corneal scarring and a one to two line reduction in visual acuity. We surveyed 50 PRK surgeons and received responses from 17 on 30 cases of this complication, which occurs in approximately one in 300 cases. The etiology is unknown. Cases were first reported when nonsteroidal anti-inflammatory drugs, with or without occlusive contact lens, were substituted for conventional bandage occlusion in the postoperative protocol for PRK.