Abstract
Purpose: :
To investigate epithelial ingrowth cells after laser in situ keratomileusis (LASIK) with clinical, histopathological and immunohistochemistry features.
Methods: :
After LASIK a 28 year–old woman required 10 months follow–up for an epithelial ingrowth (EI). Because the EI size was increasing, it was removed surgically. Histopathological analysis of the sample was performed using an optical microscope (OM). Specific antibodies expression (P63, K3 and K19) were analyzed using immunoperoxydase (IP) technique.
Results: :
EI size increased during the 10 months follow–up. Using OM, cells localized in the EI were healthy and looked like corneal epithelial cells. They constituted a pluristratified epithelium. Using IP technique, corneal epithelial ingrowth cells exhibited P63, usually expressed in limbal stem cells, and K3, a specific corneal epithelial keratin. K19 was not expressed.
Conclusions: :
Cells involved in EI after LASIK are thought to originate from the flap border, i.e. 1.5 mm from the limbus. In our study, corneal epithelial cells included in the EI lived and renewed themselves for 10 months below the flap without limbus contribution. The characteristics of those cells included self–renewal for a long period of time and differentation into at least one lineage (corneal phenotype). We cannot conclude that cells involved in EI after LASIK are stem cells, but our datas suggest that those cells have a higher rate of division than expected.
Keywords: cornea: stroma and keratocytes • refractive surgery: LASIK • cornea: epithelium