Management of delayed corneal epithelial healing after refractive surgery: 5 case reports

Chunxiao Yan ^1,2 Jin Lin ¹ Qiaosi Zhang ¹ Xiaoyu Liu ¹ Taorui Yu ¹ Fangkun Zhao ³ Yanan Mu ¹ Lijun Zhang ^1* Jun Xu ^1*

• ¹ Dalian No.3 People's Hospital, Dalian, China
• ² Dalian Medical University, Dalian, Liaoning, China
• ³ China Medical University, Shenyang, Liaoning Province, China

Technology (SPT-TransPRK) is currently the dominant superficial refractive surgery with the advantages of non-contact intraoperatively, shorter operation time and excellent patient cooperation. The laser ablation of the corneal epithelium, bowman membrane and the stroma could correct the refractive error. Therefore, completely healing of the corneal epithelium after surgery is a guarantee of good vision. The refractive surgeon should enhance the understanding of the healing mechanism of corneal wound healing and pay attention to the repair of the corneal epithelium after refractive surgery to ensure the quality of visual health of our patients.Case presentation: 5 patients had experienced different degrees of delayed corneal epithelial healing after refractive surgery. In case 1, the unhealthy corneal epithelial debris were removed and ophthalmic ointment was used to wrap the eyes instead of bandage contact lenes (BCLs) to reconstruct the corneal epithelial barrier. The method mentioned above was applied successfully to case 2. Moreover, the amniotic membrane transplantation (AMT) could quickly become a corneal barrier and promote corneal epithelial regeneration especially for extensive corneal epithelial detachments. The other 3 patients were suspected to have been diagnosed with corneal virus infection by tracing the history and observing the corneal pathology with slit lamp microscope. Further infection was prevented and regeneration promoted by early suspension of topical steroid drops, early administration of topical antiviral and corneal epithelial regeneration drugs combined with systemic antiviral therapy. Steroid drops were resumed after corneal epithelial healing to effectively prevent post refractive haze.The delayed corneal epithelial healing after refractive surgery should be taken seriously. BCLs, steroids, topical and systemic antiviral therapy should be properly applied when delayed corneal epithelial healing occurred.