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A. Jaen, Sr., C. Perez, R. Velasco, O. Baca, A. Babayan; Epithelial Behavior Post Lasek vs Epi Lasik Evaluated by Confocal Microscopy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3881.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the behavior and morphology of the corneal epithelial structure in the early postoperative period after laser sub-epithelal keratectomy (LASEK) and Epi LASIK procedures by confocal microscopy.
Prospective, longitudinal, comparative, non randomized case series at the cornea department of the Fundacion Hospital Nuestra Señora de la Luz; between April 2005 and October 2006. We included patients with an age between 21 to 50 years and with a refractive error less than 6 D of spherical equivalent . Patients were divided in two groups depending on the refractive technique done: Group 1 : Epi LASIK with the Moria Epi-K ; and Group 2 LASEK. Both groups were evaluated with confocal microscopy ( Confoscan 3, Nidek) at 1,4,7,15 and 30 days postoperative. The images obtained were analyzed with the Navis 4.3.1 software. The following variables were noted: Cell density, layer organization, epithelium- stroma interphase. Cell density was calculated in a 0.0192mm2 area . Statistical analysis was carried with t test and chi square.
By confocal microscopy we observed in the 1st postoperative day, that both groups preserve viable basal cells in the epithelial flap with slightly loss in their morphology, the Epi-LASIK group had a epithelial flap preserving better cell morphology and organization in a single layer. Both groups showed a diminished average cell count that began to recover at the 7th day. Preoperative cell density Group 1: 89.4, Group 2: 93.9. 1st day postoperative cell density Group1:50.6, Group2: 53.8, by 7 day postoperative Group1: 63.9, Group 2: 68.1, by 15 day Group 1: 72.2, Group 2: 73.98, at 30 day postoperative Group 1: 91.3, Group 2: 93.4 , 1 month after surgery both groups reached cell counts at a preoperative value. The layer organization was 62.5% for Group1, 20% Group 2 at the 1st postoperative day, by day 7 Group 1:68%, Group 2: 75%, by day 15 Group 1:100% , Group 2: 85%, by day 30 had 100% of cell layer organization.
We observed viable cells in the 1st postoperative day in eyes treated with both Epi-LASIK and LASEK. There are no differences in cell count, morphology and cell organization at 1 month after surgery.
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