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J. M. Burka, K. S. Bower, D. A. Sediq, J. D. Edwards, R. D. Stutzman, R. C. VanRoekel, C. P. Kuzmowych, R. S. Howard; Endothelial Cell Density Following Surface Ablations for Moderate and High Myopia. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3355.
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© ARVO (1962-2015); The Authors (2016-present)
To compare changes in corneal endothelial cell counts after 3 types of surface ablations, photorefractive keratectomy (PRK), PRK with mitomycin C (MMC), and laser assisted subepithelial keratomileusis (LASEK).
Active Duty Army soldiers, age 21 or over with stable myopia between -4.00D and -10.00D manifest spherical equivalent (MSE) were randomized to treatment of their dominant eye with either MMC-PRK (0.1 mg/ml x 1 minute) or LASEK. The fellow eye received conventional PRK. All procedures were performed using the LADARVision 4000 with Jupiter 2 software version 5.11. Endothelial cell counts were measured both preoperatively and at 6 and 12 months postoperatively with the Nikon Confoscan.
193 subjects (97 PRK, 42 PRK with MMC and 54 LASEK) with follow-up at 6 months and 138 (69 PRK, 29 PRK with MMC and 40 LASEK) with follow-up at 12 months were analyzed for this report. For the PRK group there was found to me a median loss of 37 cells/mm2 (range: -1092 to 633) at 6 months post-operatively and 94 cells/mm2 (range: -682 to 890) at 12 months. This change was statistically significant at 12 months (p=0.001). For the PRK with MMC group there was a median loss of 55 cells/mm2 (range: -574 to 672) at 6 months and 35 cells/mm2 (range: -605 to 882) at 12 months, neither of which was statistically significant (p=0.344 and 0.429 respectively). Additionally, there was no significant change for the LASEK group with a median loss of 17 cells/mm2 (range: -936 to 543) at 6 months and a median gain of 37 cells/mm2 (range: -789 to 791) at 12 months (p=0.911 and 0.259 respectively). There was a significant difference between the 3 groups at 12 months with p=0.021. This difference was found to be primarily between the PRK and LASEK groups with p=0.004.
There is a significant decrease in endothelial cell counts following PRK, however, PRK with MMC and LASEK appear to have no effect.
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