[Corneal stromal changes after LASIK].
OBJECTIVE
To assess stromal modifications after laser in situ keratomileusis (LASIK) for myopia using in vivo confocal microscopy.


METHODS
Thirteen eyes from 10 patients were examined before surgery and at days 8 and 30 after surgery using an in vivo confocal microscope coupled with a Z-Scan system. Stromal morphological changes, keratocyte density, flap thickness, and subclinical haze were evaluated and compared at different time points.


RESULTS
Microfolds at the Bowman's layer were found in 55%, eyes as well as variable reflectivity particles located at the interface level in all postoperative examined eyes. The mean flap and activated-cell area thicknesses were respectively, 101+/-28 micrometer and 50.5+/-14 micrometer with a significant negative correlation (r=-0.89, p=0.01). The intensity of the added peak (47.3+/-8.6% scattered light), corresponding to the subclinical haze, as measured by Z-Scan, was also negatively correlated with the flap thickness (r=-0.89, p=0.01).


CONCLUSIONS
This study confirms the presence of microfolds and particles at the interface level as subclinical complications. Evaluating the keratocytic activation by confocal microscopy can lead to a better understanding of corneal wound healing after LASIK and can help to improve the techniques. The flap thickness seems to be involved in the cellular activation induced by LASIK.
Auzerie
O
O
Service d'Ophtalmologie, Hôpital Ambroise Paré, APHP, UFR Paris-Ouest, 9, avenue Charles de Gaulle, 92100 Boulogne-Sur-Seine.
Pisella
P J
PJ
Bokobza
Y
Y
Baudouin
C
C
D000328:Adult; D003315:Cornea / Q000473:pathology*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged