Observation of corneal flap interface in existence of metal particles from microkeratome blade

Abstract

Abstract: : Purpose: To determine whether metal particles from microkeratome blades during laser in situ keratomileusis (LASIK) cause inflammatory reactions such as diffuse lamellar keratitis (DLK) in rabbit eyes. Methods: Corneal flaps were created in 19 eyes of rabbits by using ACS microkeratome (automated corneal shaper; Bausch & Lomb). Using a diamond file (#400 grain size), metal particles were scraped from microkeratome blade and placed on the stromal bed in 15 eyes. Corneal flap was repositioned without laser ablation. Four eyes from the control group did not receive any metal particles. Slit–lamp and histopathologic examinations were conducted at 3 and 14 days, and 1 and 3 month postoperatively. Changes of the metal particles were also examined. Results: Slit–lamp examination showed metal particles at the flap interfaces but no DLK or corneal opacification in 14 of the 15 eyes (95%). One eye had a slight gap at the flap edge and developed mild DLK–like changes. Flap interface was clear in all eye of control group. Histopathological examinations revealed no obvious changes at the flap interfaces in any eyes or around the metal particles. Conclusions: The simple existence of metal particles in corneal flap interface did not cause any inflammatory reactions. Longer follow–up and further study are necessary including non–metallic material on the blade surface.

Keywords: refractive surgery: complications