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Drug Delivery for the Retina and Posterior Segment Disease pp 439–477Cite as

Corneal Haze, Refractive Surgery, and Implications for Choroidal Neovascularization

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Abstract

Visual impairment is a multifactorial issue affecting 285 million people world-wide and influencing their quality of life. Although surgical procedures such as photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK), laser sub-epithelial keratomileusis (LASEK), and implantation of synthetic intra-ocular lenses have shown promise in correcting refractive errors, post-operative complications represented by blurry vision (corneal haze) are widely recorded, with the duration of the symptom varying with each case from a few days to months. In addition to surgical procedures, corneal injuries such as alkali burns, infections, etc. cause keratocyte apoptosis, which triggers a wound-healing cascade leading to corneal haze. Corneal haze is the result of aggressive wound healing and the formation of scar tissue post-surgery, which involves the differentiation of keratocytes to myofibroblasts causing fibrosis, and unorganized deposition of collagen types IV and VII leading to reduced ocular clarity. Therefore, the goal of future research is to promote wound healing through regeneration without fibrosis, and reducing the oxidative damage caused by reactive oxygen species. Consequently, significant research is being undertaken in reducing these complications, in addition to increasing the efficacy of the existing drug formulations to reduce ocular toxicity, corneal haze, and reduce the rate of wound healing. This chapter presents a comprehensive review of the current treatments available, and new prospects for therapy.

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Acknowledgements

The authors are grateful to the National Health and Medical Research Council (NHMRC; APP1050286) and Australia-India Strategic Research Fund (AISRF).

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  1. Nanomedicine Laboratory of Immunology and Molecular Biochemical Research (NLIMBR), Centre Molecular and Medical Research (CMMR), School of Medicine, Faculty of Health Deakin University, Waurn Ponds, VIC, Australia

    Amitoj Singh, Afrah Jalil Abd, Aseel Al-Mashahedah & Jagat Rakesh Kanwar

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  1. Amitoj Singh
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  2. Afrah Jalil Abd
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  3. Aseel Al-Mashahedah
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  4. Jagat Rakesh Kanwar
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Correspondence to Jagat Rakesh Kanwar .

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  1. Faculty of Pharmacy, Sankalchand Patel University, Gujarat, India

    Jayvadan K. Patel

  2. College of Pharmacy, University of South Florida, Tampa, FL, USA

    Vijaykumar Sutariya

  3. School of Medicine, Faculty of Health, Deakin University, Victoria, Australia

    Jagat Rakesh Kanwar

  4. College of Pharmacy, University of South Florida, Tampa, FL, USA

    Yashwant V. Pathak

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Singh, A., Abd, A.J., Al-Mashahedah, A., Kanwar, J.R. (2018). Corneal Haze, Refractive Surgery, and Implications for Choroidal Neovascularization. In: Patel, J., Sutariya, V., Kanwar, J., Pathak, Y. (eds) Drug Delivery for the Retina and Posterior Segment Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-95807-1_25

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