Corneal epithelial healing after lasik surgery
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Category: P5 Refractive. Corneal Epithelial Healing After LASIK Surgery. Yousuf Khalifa, MD Tracie Sponseller, OD David Bogorad, MD. Introduction. LASIK flap creation and stromal ablation elicit healing responses in the corneal epithelium and stroma

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Category: P5 Refractive

Corneal Epithelial Healing After LASIK Surgery

Yousuf Khalifa, MD

Tracie Sponseller, OD

David Bogorad, MD


Introduction l.jpg
Introduction

  • LASIK flap creation and stromal ablation elicit healing responses in the corneal epithelium and stroma

  • Physiology of corneal stroma healing after LASIK surgery has been described

  • Corneal epithelial wound healing after LASIK surgery has not been reported previously to our knowledge

  • Insights into the factors involved in corneal epithelium healing can be drawn from LASIK surgery


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Methods

  • 65 consecutive LASIK surgery patients were included

  • LASIK flaps created with the Moria M2 microkeratome, with Moria disposable heads, using published nomograms

  • Alcon Ladarvision 4000 platform used

  • Conventional, Custom, Myopic, and Hyperopic corrections included

  • Prednisolone Acetate 1% and Vigamox were prescribed tid along with Systane qid + prn

  • Patients evaluated at postoperative day 1 with fluorescein staining to assess number of clock hours healed


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Methods

  • Patient age, sex, treatment refraction, microkeratome suction ring and flap thickness, ablation depth, time of LASIK, elapsed time from surgery, number of stained clock hours entered into Excel spreadsheet

  • SAS version 9.1 was used for all analyses and statistical significance was assessed at the 5% level




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Results

A Bland-Altman plot illustrates that the majority of the eyes within each subject are within the limits of agreement. Thus, the measurement of clock hours is in agreement for the two eyes within each subject and that healing did not differ between the eyes.





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Discussion

  • LASIK surgery is an ideal model to study human epithelial wound healing

    • Our results show that suction ring size, flap thickness, ablation depth have no correlation with epithelial healing

    • Fluorescein staining is a simple, safe, clinically accepted means of assessing epithelial integrity

    • Our study lays the foundation for future studies looking at factors that influence epithelial healing

  • Postoperative Day 1 is an excellent window to assess the epithelial healing because of the range of healed clock hours. In our study the elapsed time from surgery ranged from 16 to 26 hours.


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Discussion

  • OD and OS healing rates are consistent within each patient

    • Using the same blade on the OS after the OD does not affect epithelial healing

  • Between 16 and 26 hours after LASIK surgery the epithelial healing varies; but the further out from surgery, the more likely to have more healed clock hours

  • Age did not closely correlate

  • Smoking status did not correlate

    • This study is likely underpowered to determine the effects of smoking