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D. Parmar, P.M. Ladage, S. Awwad, J.P. McCulley, R.W. Bowman, H.D. Cavanagh; Corneal Epithelial Homeostasis Following Laser in situ Keratomileusis (LASIK) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):901.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the corneal epithelial response following LASIK.Methods: 14 corneas of 7 patients undergoing routine LASIK were prospectively enrolled, 3 male and 4 female. Corneal epithelial exfoliation rate (EXFR) was assessed using a non–contact corneal irrigation chamber (NCIC) preoperatively and at 1, 3 and 6 months postoperatively. Collected corneal epithelial cells were stained with Acridine Orange dye and counted by fluorescence microscopy. Corneal epithelial thickness was measured by tandem scanning corneal confocal microscopy preoperatively and at 6 months postoperatively. Results: At an irrigation rate of 9mL/min, mean preoperative EXFR was 38.5 ±15.6 cells/min, increasing significantly to 53.9 ±16.9cells/min at 1 month postoperatively (Student’s t–test, P≤0.005), but returning to preoperative levels by 3 months (36.7 ±12.4 cells/min) and 6 months (33.4 ±13.2 cells/min). An increase in mean central corneal epithelial thickness was seen 6 months postoperatively (50.2 +/– 4.5 µm) compared to preoperative values (46.2 +/– 4.8 µm), although this was not statistically significant. Conclusions: Corneal epithelial desquamation rate increases in the first month following LASIK, returning to normal levels by 3 months, without any significant change in central corneal epithelial thickness. This may be related to altered lid–shearing forces at the edge of the stromal ablation zone causing a temporary increase in apoptotic–driven corneal epithelial desquamation.
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