Confocal Microscopy Findings After PRK and Amniotic Membrane Transplantation

Abstract

Purpose: : To evaluate the findings of Confocal Microscopy with patients who underwent Phothorefractive keratectomy(PRK) and Amniotic Membrane placement.

Methods: : This is a case report. Prospective study that included patients who underwent PRK and amniotic membrane. The inclusion criteria for PRK was based on regular protocol of the department of cornea. Preoperative and postoperative confocal microscopy, visual acuity, slit lamp examintation and digital photographs were done. PRK with alcohol 20% for epithelial removal was instilled. Stromal ablation using Chiron technolas 217, preserved amniotic membrane was placed over the entire cornea and sutured with 6 10–0 nylon single stitches. Soft contact lens at the end of the procedure was used. Symptoms were related with the procedure.

Results: : Two cases were included. Amniotic membrane was on the corneal surface for 5 days. Total re–epithelialization at 48 hrs after surgery. Uncorrected visual acuity with amniotic membrane was 20/30 and 20/20 without it. By confocal microscopy no epithelial cells were seen at the first 24 hrs. Activated keratocytes in anterior and mid stroma at 48 hrs after surgery. Hypo–reflective keratocytes in posterior stroma during the first 15 days. No sub–basal plexus was seen. Endothelium remain normal. Early stromal wound healing since 48 hrs after surgery. No symptoms were reported

Conclusions: : Amniotic membrane after PRK, reduces discomfort , improves the time of recovery, and promotes the keretocyte activity in the superficial layer of the cornea.

Keywords: cornea: epithelium • microscopy: confocal/tunneling • refractive surgery: PRK