Abstract
Abstract: :
Purpose: To study the effect of a single keratome cut on micromorphology and biomechanics of the human cornea. Methods: Four eyes of three patients who underwent a keratome cut for bioptics procedure were examined with confocal microscopy (Confoscan P4, Tomey) 1 hour, 1 day, 1 week and 1 month after microkeratome cut. Orbscan II-examinations (Bausch&Lomb) were performed preoperatively and 1 month postoperatively. Results: All eyes had normal appearance the first postoperative day. One hour postoperatively, confocal microscopy showed diffuse epithelial desquamation and discrete folds in the posterior stroma. The first postoperative day, the epithelium was normal, but all eyes showed microfolds in the flap stroma. At the interface, highly reflective debris particles were visible. One week and one month after the keratome cut the appearance was similar. Orbscan examinations revealed only discrete changes of elevation of the anterior surface, whereas one month postoperatively in all eyes a mean forward shift of the posterior surface of 3,8µm (+/-2,5) µm could be detected. Conclusion: Most of the changes detectable with confocal microscopy after LASIK are caused by the keratome cut, whereas the cut only has limited biomechanical effects.br /≷
Keywords: 548 refractive surgery: LASIK • 547 refractive surgery: corneal topography • 374 cornea: stroma and keratocytes