New fixation device for photorefractive surgery and its effect on corneal epithelial wound healing.
OBJECTIVE
A new eyeball fixation device during photorefractive surgery was designed and tested. The device fixates the eyeball by means of a suction ring, and is then fixated to the headrest of the patient's chair via clipper and metal frames.


METHODS
Photorefractive keratectomy (PRK) was performed on PMMA contact lenses placed over the patient's cornea (n=6) to evaluate smoothness of the ablated surface and on rabbit (n=24) and patient (n=30) corneas for evaluation of wound healing time. Decentration with fixation was examined using videokeratography after PRK.


RESULTS
After fixation, only small amounts of corneal movement from the patient's pulsating heart were noted. The mean smoothness (root mean square) of the PMMA contact lens ablated surface was 0.43 +/- 0.16 microm in non-fixated eyes and 0.26 +/-0.05 microm in fixated eyes. Mean epithelial healing rate was 47.93 +/- 21.80 microm/hr in non-fixated rabbit eyes and 66.49 +/- 20 microm/hr in fixated rabbit eyes. Mean epithelial healing time was 3.47 +/- 1.11 days in non-fixated human eyes and 2.53 +/- 0.51 days in fixated human eyes. Mean decentration after PRK was 0.30 +/- 0.28 mm in fixated human eyes.


CONCLUSIONS
Fixating the eyeball allows less movement of the eye and achieves a smoother ablation surface for more rapid epithelial healing after PRK.
Kim
E K
EK
Department of Ophthalmology, Yonsei Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Lee
D H
DH
Park
J W
JW
Chu
Y K
YK
Seo
K Y
KY
D000328:Adult; D000818:Animals; D019781:Corneal Topography; D019573:Epithelium, Corneal / Q000473:pathology* / Q000601:surgery; D004867:Equipment Design; D005133:Eye Movements; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000473:pathology* / Q000601:surgery; D018903:Photorefractive Keratectomy / Q000295:instrumentation*; D011817:Rabbits; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing