Abstract
Abstract: :
Purpose:To compare corneal wound healing (epithelial and stromal)- using in vivo confocal microscopy- after laser epithelial keratomileusis (LASEK) vs photorefractive keratectomy (PRK) in myopic eyes. Methods:34 myopic patients were randomized to LASEK in one and PRK in the fellow eye. Treatment was performed in a standard fashion. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), postoperative pain and cornel reepithelization were evaluated daily for 4 days, and then monthly. Corneal confocal microscopy was performed at each follow up examination to quantify epithelial and stromal wound healing process. Patients and examiners were masked about treatment procedure. Results:Mean pre-op vs post-op refractive errors were: LASEK eyes: -3.95 1.29 D vs + 0.22 0.79 D (p= .005); PRK eyes: -4.37 1.35 D vs - 0.37 0.61 D (p=.008). Refractive results, UCVA, BCVA, and corneal reepithelization were not significantly different in the two treatment groups during follow-up. Pain score was significantly (p=.02) higher in LASEK vs PRK treated eyes. At confocal microscopy, no morphologic difference was observed in LASEK vs PRK treated eyes in the early post-op follow-up; at one month and thereafter, LASEK treated eyes had significantly less activated keratocytes (p=.005) and stromal extracellular matrix (p=.009) compared to PRK eyes. Conclusion:LASEK seems to modulate corneal wound healing process, reducing stromal corneal responses to excimer laser photoablation when compared to standard PRK.
Keywords: 471 microscopy: confocal/tunneling • 631 wound healing • 374 cornea: stroma and keratocytes