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M.E. Mulet, M.J. Ayala, T. Salem, M.T. Vidal, V. Baeyens, L.F. Zapata, J.L. Alio; Quality of Vision Following Stromal Smoothing After Excimer Laser Surgery Assisted by 0,25 % Sodium Hyaluronate (ELASHY)(LASERVIS ®) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2622.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the effect of the ELASHY technique on corneal surface quality and corneal stroma wound healing. Methods: This was a randomised, masked-controlled study. 29 bilateral myopic patients (58 eyes) were included (20 females and 9 males). Mean age was 31.9 ±6.4 years and mean myopia –6.02 ±1.87. Eyes of patients were divided into two groups. Group 1: Elashy technique with Laservis®. (TRB Chemedica, Switzerland) as a masking fluid. Group 2: Standard Lasik technique.l Lasik technique was performed with Technolaser 217 C (Bausch & Lomb, USA) and M-2 microkeratome (Moria.France). Postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive outcome, corneal thickness, slit lamp examination and corneal topography, including parameters of corneal surface quality by ray-tracing analysis C-Scan (Technomed,Germany) were evaluated: Superficial corneal surface quality (SCSQ), image distortion (ID) and potential corneal visual acuity (PCVA). Corneal confocal microscopy (ASL500.Advanced Scanning.New Orleans.USA) was used to evaluate the biological reaction of the corneal stroma and wound healing activity. 6 months follow-up Results: There were no differences in the refractive results between both groups. Group 1: Mean postoperative UCVA was 1± 0.0 (1,1), mean pachymetry 463.2 ±48.2µ (390,550) and PCVA was 1.05±0,24 (1,2). ID was 7,7±1.3 (6,10) and mean SCSQ was 89.60 ± 5,9 (78,98). Group 2:Mean postoperative UCVA was 1.0 ±0,0.(1,1) and mean pachymetry was 467.3±42,6 µ (410,550). Mean PCVA was 1,1±0.34 (1,2). Mean ID was 8.05 ±1,6 (6,11) and mean SCSQ was 87.8 ±9,0 (75,99).Confocal microscopy: Differences in wound healing activity were observed between groups: less keratocyte activation with less associated extracellular matrix production was observed in all cases of the ELASHY group. Other morphological parameters proved to be better in cases operated with the smoothing technique. Conclusions: Smoothing with the ELASHY technique using 0,25% sodium hyaluronate significantly improves the parameters of corneal surface quality and activates less the wound healing process following Lasik. Further studies are necessary to investigate the causative mechanism of the improved outcome that the ELASHY technique produces on the wound healing process.
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