title: Ocular integrity after refractive procedures.
abstract: OBJECTIVE
  The purpose of the study was to determine the integrity of human eyes after refractive procedures.
  
  
  METHODS
  Whole human globes underwent either radial keratotomy (RK) with eight incisions, automated lamellar keratoplasty (ALK), photorefractive keratectomy (PRK), or excimer laser assisted in situ keratomileusis (LASIK). Eyes then were subjected to quantitatively increasing levels of trauma until rupture occurred.
  
  
  RESULTS
  All eyes operated on required less energy to rupture as compared with that of control eyes. The mean number of trials required for rupture is as follows (energy doubled with each successive trial): normal, 4.29; LASIK, 3.80; ALK, 3.67; PRK, 3.60; and RK, 2.83. The level of energy required to rupture normal, ALK, PRK, and LASIK eyes was not significantly different. All RK eyes ruptured at incisions. Most ALK, PRK, and LASIK eyes ruptured near the flap edge or limbus. Most normal eyes ruptured with both corneal and scleral involvement. Age of tissue donors at the time of death and time elapsed between death and procedure were not significantly different between groups (P = 0.88 and 0.79, respectively).
  
  
  CONCLUSIONS
  The energy required to rupture ALK, PRK, and LASIK eyes is not significantly different from that for normal eyes. The RK eyes ruptured with significantly less energy than did normal eyes. All RK eyes ruptured at incision sites.
authors.affiliation: University of Texas Health Science Center at Houston, Department of Ophthalmology and Visual Sciences, USA.
authors.forename: L W
authors.initials: LW
authors.lastname: Peacock
authors.forename: S G
authors.initials: SG
authors.lastname: Slade
authors.forename: J
authors.initials: J
authors.lastname: Martiz
authors.forename: A
authors.initials: A
authors.lastname: Chuang
authors.forename: R W
authors.initials: RW
authors.lastname: Yee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000601:surgery; D016039:Corneal Transplantation; D005123:Eye / Q000503:physiopathology*; D005131:Eye Injuries / Q000503:physiopathology*; D006801:Humans; D007646:Keratotomy, Radial; D008875:Middle Aged; D011184:Postoperative Period; D054140:Refractive Surgical Procedures; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000503:physiopathology*