medigraphic.com
ISSN 1561-3070 (Electronic)

2013, Number 2

<< Back Next >>

Rev Cub Oftal 2013; 26 (2)

In vivo characteristics of the corneal epithelium vs size of the refractive error after Excimer laser treatment

Rojas ÁE, González SJ, Miranda HI, Pérez RA

Language: Spanish
References: 18
Page: 208-217
PDF size: 481.18 Kb.


ABSTRACT

Objective: to describe the in vivo characteristics of the corneal epithelium and their association with the size of the treated refractive defect after LASIK.
Methods: a prospective, longitudinal and descriptive study of 24 patients (48 eyes) with myopic astigmatism, who were operated on by using ESIRIS (Schwind-Germany) and LASIK technique with pendular microketatome. Summary statistic techniques served to analyze results. NIDEK´s ConfoScan 4 microscope was used to obtain and to study in vivo corneal tissue images.
Results: mean central epithelial thickness measured in the preoperative stage was 34.7 µm, but increased by 36% seven days after surgery in patients with refractive defects fewer than 4D and by 44% in patients with refractive defects equal to or over 4D. The average cell density of the basal epithelium 7 days postoperatively was 5 098.3±1 654 cell/mm2 and showed minimal changes below 1% during the study period.
Conclusions: the central corneal epithelium thickness increased after LASIK surgery and it was higher in refractive defects over 4D. Cell density of the basal epithelium did not show significant changes and was not associated to the size of the treated refractive defect.


REFERENCES

  1. Erie JC, Patel SV, McLaren JW, Ramirez M, Hodge DO, Maguire LJ, et al. Effect of myopic laser in situ keratomileusis on epithelial and stromal thickness: a confocal microscopy study. Ophthalmology. 2002;109(8):1447-52.

  2. Morishige N, Takahashi N, Chikamoto N, Nishida T. Quantitative evaluation of corneal epithelial edema by confocal microscopy. Clinical & Experimental Ophthalmology. 2009;37(3):249-53.

  3. Hjortdal J, Moller-Pedersen T, Ivarsen A, Ehlers N. Corneal power, thickness, and stiffness: results of a prospective randomized controlled trial of PRK and LASIK for myopia. J Cataract Refract Surg. 2005;31(1):21-9.

  4. LaGier AJ, Yoo SH, Alfonso EC, Meiners S, Fini ME. Inhibition of human corneal epithelial production of fibrotic mediator TGF-_2 by basement membranelike extracellular matrix. Invest Ophthalmol Vis Sci. 2007;48(3):1061-71.

  5. Fournie PR, Gordon GM, Dawson DG, Edelhauser HF, Fini ME. Correlations of long-term matrix metalloproteinase localization in human corneas after successful laser-assisted in situ keratomileusis with minor complications at the flap margin. Arch Ophthalmol. 2008;126(2):162-70.

  6. Jung JC, Huh MI, Fini ME. Constitutive collagenase-1 synthesis through MAPK pathways is mediated, in part, by endogenous IL-1 during fibrotic repair in corneal stroma. J Cell Biochem. 2007;102(2):453-62.

  7. Patel SV, Erie JC, McLaren JW, Bourne WM. Confocal microscopy changes in epithelial and stromal thickness up to 7 years after LASIK and photorefractive keratectomy for myopia. J Refract Surg. 2007;23(4):385-92.

  8. Reinstein DZ, Silverman RH, Raevsky T, Simoni GJ, Lloyd HO, Najafi DJ et al. Arc-scanning very high-frequency digital ultrasound for 3D pachymetric mapping of the corneal epithelium and stroma in laser in situ keratomileusis. J Refract Surg. 2000;16(4):414-30.

  9. Reinstein DZ, Archer TJ, Gobbe M, Silverman RH, Coleman DJ. Epithelial thickness in topography of the normal cornea: threedimensional display with Artemis very high-frequency digital ultrasound. J Refract Surg. 2008;24(6):571-81.

  10. Moilanen JA, Holopainen JM, Vesaluoma MH, Tervo TM. Corneal recovery after LASIK for high myopia: a 2-year prospective confocal microscopic study. Br J Ophthalmol. 2008;92(10):397-402.

  11. Huang D, Tang M, Shekhar R. Mathematical model of corneal surface smoothing after laser refractive surgery. Am J Ophthalmol. 2003;135(3):267-78.

  12. Reinstein DZ, Archer TJ, Silverman RH, Coleman J. Epithelial Thickness After Hyperopic LASIK: Three-dimensional Display With Artemis Very High-frequency Digital Ultrasound. J Refract Surg. 2010;26(6):555-64.

  13. Ivarsen A, Fledelius W, Hjortdal JO. Three year changes in epithelial and stromal thickness after PRK or LASIK for high miopía. Invest Ophthalmol Vis Sci. 2009;50(5):2061-6.

  14. Reinstein DZ, Srivannaboon S, Gobbe M, Archer TJ, Silverman RH, Sutton H, et al. Epithelial Thickness Profile Changes Induced by Myopic LASIK as Measured by Artemis very High-frequency Digital Ultrasound. J Refract Surg. 2009;25(5):444-50.

  15. Spadea L, Fasciani R, Necozione S, Balestrazzi E. Role of the corneal epithelium in refractive changes following laser in situ keratomileusis for high myopia. J Refract Surg. 2000;16(2):133-9.

  16. Reinstein DZ, Ameline B, Puech M, Montefi G, Laroche L. VHF digital ultrasound three-dimensional scanning in the diagnosis of myopic regression after corneal refractive surgery. J Refract Surg. 2005;21(5):480-4.

  17. Tanioka H, Hieda O, Kawasaki S, Nakai Y, Kinoshita S. Assessment of epithelial integrity and cell viability in epithelial flaps prepared with the epi-LASIK procedure. J Cataract Refract Surg. 2007;33 (7):1195-200.

  18. Kaufman SC, Kaufman HE. How has confocal microscopy helped us in refractive surgery? Curr Opin Ophthalmol. 2006;17(4):380-8.




2020     |     www.medigraphic.com