Histology After EpiLASIK With the Visijet EpiLift Microkeratome

Abstract

Abstract: : Purpose: With LASEK surface ablation is getting more and more popular. Instead of the ethanol in LASEK a new technique the EpiLASIK has been introduced as a new technology for refractive surgery. With this technique the epithelial separation is performed mechanically with a microkeratome.There are different modifications of the microkeratomes. Aim of this study was to look at the plane of the cut and the viability of the epithelial cells after EpiLASIK with the Visijet EpiLift mikrokeratome. Methods: Human corneas, which were not suitable for transplantation, were obtained from Bristol eye bank. An EpiLASIK cut was performed on 5 human corneas with the EpiLift microkeratome and the epithelium and the stromal bed were embedded for light and electron microscopy in paraformaldehyde. In 5 corneas the cuts were made and the cell viability of the epithelial flap cells wrer investigated with trypan blue method. Results: The cut appears very smooth. In light microscopy the epithelium was separated above the bowmans layer from the Stroma. Scanning laser microscopy showed a smooth cut and sharp edges at the cut edge. There was no disruption of the bowman's membrane. In transmission electron microscopy the plane of the cut was between the bowmans layer and the basal cells. Over 95 % of all cells were viable direct after the cut. Conclusions: Mechanical separation did not affect the normal cell morphology. As the wound is covered with an intact epithelial sheet, this could lead to less pain and a faster visual recovery.

Keywords: cornea: epithelium • cornea: stroma and keratocytes • refractive surgery: other technologies