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C.R. Parez, O. Baca, R. Velasco, D. Viggiano, A. Babayan, A. Guerra; Epithelial Behavior After Lasek vs Epilasik by Confocal . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3614.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the behavior of corneal epithelium after LASEK and EpiLASIK using confocal microscopy.
A prospective, longitudinal, comparative study was undertaken between April to October of 2005. Patients who underwent superficial refractive surgery, older than 21 years, were included. We divided cases into three groups. Group 1: eyes with Epilasik (Epi–K, Moria). Group 2:eyes with Epilasik (Centurion SES), and Group 3: eyes with LASEK. Patients were seen preoperatively (preop) and postoperatively (postop) at 1°, 4°, 6°, 13° y 30° day. Basal cells first day seen and morphology, morphology and organization of epithelial cells were studied. Basal cell count was done in a 0.0192 mm2 area. Uncorrected visual acuity with logMar conversion (UCVA) were related with confocal findings.
11 eyes were included. The mean preop basal cell count in the 3 Groups was 107 cells/constant area, at 4° day no basal cells were seen in Group 2. The recovery of cells during the first month was 72 cells for Group 1, 98 for Group 2 and 95 for Group 3, only Group 3 had the same number of cells pre and postop (p < 0.0001). By confocal microscoscopy we observed, in the 1st. postop day, those eyes who were in Group 3 and Group 1 preserved viable intermediate and basal cells in the epithelial flap, with a slightly loss in their morphology. Basal epithelial cell regeneration was faster in Group 1 and with a more differentiated morphology than in Group 2 and 3 at the 4th postop day. UCVA was in the first day 0.18 Group 1, 0.7 Group 2, 0.5 Group 3, 13° day 0.1 Group 1, 0.18 Group 2, 0.3 Group 3, 1° month 0.1 Group 1, 0.1 Group 2, 0.1 Group 3, these findings were related with less postop symptoms and a better UCVA.
Epithelial cell count increased in each visit, normal values at 1 month postop. The fastest regeneration occurred in Group 3. UCVA recovery is related with epithelial cell differentiation and organization. No significant differences in the cellular morphology, epithelial layer organization and visual recovery in the three groups during the first month after surgery.
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