Corneal wound healing after laser in situ keratomileusis flap lift and epithelial abrasion.
We report the clinical and confocal microscopic findings of wound-healing reactions after epithelium debridement and flap lift for the treatment of folds in a thin laser in situ keratomileusis (LASIK) flap. A 30-year-old woman had a flap lift with deepithelialization because of persistent striae after LASIK. The patient developed stage 2 diffuse lamellar keratitis (DLK) and dense haze. Confocal microscopy showed a loss of the most anterior keratocytes 6 days after flap relifting and deepithelialization. Subsequently, stromal repopulation with the appearance of spindle-shaped fibroblasts and activated keratocytes was detectable. Two months postoperatively, a maximum of haze tissue was found at the interface level and a myopic shift of -2.00 diopters was observed. Under treatment with topical steroids, the haze resolved and the spherical equivalent returned to baseline within 12 months.
Bühren
Jens
J
Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
Kohnen
Thomas
T
D000328:Adult; D003318:Corneal Opacity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003319:Corneal Stroma / Q000187:drug effects / Q000473:pathology*; D003646:Debridement; D004847:Epithelial Cells / Q000187:drug effects / Q000473:pathology; D005260:Female; D005347:Fibroblasts / Q000187:drug effects / Q000473:pathology; D005469:Fluorometholone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D018613:Microscopy, Confocal; D012086:Reoperation; D013524:Surgical Flaps; D014945:Wound Healing
D005938:Glucocorticoids; D005469:Fluorometholone