ReviewGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Thermal load management in photorefractive keratectomy: a comprehensive review of cooling strategies.
Review in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePhotorefractive keratectomy (PRK) and Transepithelial PRK (TransPRK) are key surface ablation techniques in refractive surgery, particularly for patients ineligible for flap-based procedures. However, thermal buildup during laser ablation poses risks such as corneal haze, delayed epithelial healing, and postoperative pain. This review systematically examines current cooling strategies in PRK and TransPRK, focusing on thermal load management, laser system innovations, postoperative care, and future directions for thermal optimization.
methodsA systematic literature search was conducted using terms including “PRK,” “cooling strategies,” “thermal effects,” and “pain management.” Studies were selected based on relevance and English-language abstracts. Data were qualitatively synthesized to identify common approaches and outcomes.
resultsCooling strategies span preoperative, intraoperative, and postoperative phases. Preoperatively, cryotherapy agents such as balanced salt solution (BSS) has shown to reduce corneal surface temperature by up to 9 °C, helping maintain safe thermal levels. Intraoperatively, modern excimer laser systems utilize proprietary algorithms that modulate local repetition rates and optimize scanning patterns to minimize heat accumulation. Postoperatively, chilled BSS rinses, bandage contact lenses, and cold patches help manage inflammation and pain. Clinical practice increasingly favors an integrated approach that combines these modalities. However, no universally accepted protocols or formulations currently exist across clinical settings.
conclusionEffective cooling strategies are essential to mitigate thermal complications in PRK and TransPRK. While current modalities reduce discomfort and thermal risk, standardized, evidence-based guidelines are lacking. Future research should address this gap and further investigate potential complications such as infection risk, hypersensitivity, and delayed epithelial healing associated with certain cooling agents.
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Registered trials
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