[Vital changes in corneal structure after LASEK during the early postoperative period].
LASEK (Laser Epithelial Keratomileusis) is a new refractive surgery technique, with corneal epithelial flap formation, Excimer Laser photoablation, and subsequent flap reposition. Confocal microscopy facilitates in vivo evaluation of the corneal structure, i.e., a morphological analysis of its layers, and the monitoring of postoperative alterations.


OBJECTIVE
The purpose of the present study is to assess the corneal structure in vivo morphological after LASEK procedure with the use of confocal microscopy in the early postoperative period.


METHODS
The analyzed group of patients consisted of 50 eyes in 30 patients who underwent correction of myopia and myopic astigmatism using the LASEK procedure. The epithelial flap formation was carried out with the use of a 20% alcohol solution. The photoablation was performed with the Excimer Laser MEL 70 G-Scan Aesculap Meditec. Postoperative observations were made using a Confoscan 2 (Fortune Technologies). The evaluations were performed on the first postoperative day, and then at 1, 2, 4 and 12 weeks following surgery.


RESULTS
Confocal microscopy revealed some changes in the epithelium and corneal stroma. At the site of the photoablation the structure of collagen fibers was blurred, with increased reflectivity. No scar tissue was found. The pattern of keratoctic nuclei in the anterior corneal stroma was typical for the postphotoablation state during the whole observation period. Bowman's membrane and the subepithelial nerve plexus were absent in the central part of the cornea. The findings kept changing in the course of the follow up time.


CONCLUSIONS
Confocal microscopy enables the monitoring of changes, which occur in the corneal structure after LASEK refractive procedures; this facilitates the evaluation of corneal healing. LASEK allows for prompt stabilization of the epithelial structure and the anterior corneal stroma. No overproduction of collagen fibers was observed at the photoablation area during the healing process.
Rokita-Wala
Iwona
I
I Katedry i Kliniki Okulistyki Slaskiej Akademii Medycznej w Katowicach.
Gierek-Ciaciura
Stanisława
S
Mrukwa-Kominek
Ewa
E
Obidziński
Marek
M
D000328:Adult; D001251:Astigmatism / Q000150:complications / Q000601:surgery*; D003094:Collagen / Q000032:analysis; D003315:Cornea / Q000473:pathology*; D003319:Corneal Stroma / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D018613:Microscopy, Confocal; D009216:Myopia / Q000150:complications / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011184:Postoperative Period; D014945:Wound Healing
D003094:Collagen
Przyzyciowe zmiany struktury rogówki po LASEK-u we wczesnym okresie pooperacyjnym.