Corneal epithelial healing after photorefractive keratectomy: analytical study.
OBJECTIVE
To characterize the velocity of epithelial migration after photorefractive keratectomy (PRK) with 3 different corneal ablation patterns.


METHODS
Department of Ophthalmology, Catholic University of Rome, Rome, Italy.


METHODS
Fifteen patients (30 eyes) with mild to moderate myopia and with simple to compound myopic astigmatism were enrolled for this study. The surgical procedure consisted of standardized PRK with final smoothing performed using the Technolas Keracor 217C excimer laser. The reepithelialization process was evaluated at 0 hours, 20 hours, 40 hours, and 60 hours after surgery using a digital photo camera and custom software for measurement. Digital analysis of the images was performed. Corneal topographies were taken at 1 month, 3 months, 6 months, and 12 months after PRK.


RESULTS
The mean speed of radial migration in the 10 eyes (33%) in the low spherical ablation group was 0.087 mm/h +/- 0.008 (SD). This was significantly higher than that found in the 10 eyes (33%) in the high spherical ablation group (mean speed 0.078 +/- 0.007 mm/h; P<.001) and in the 10 eyes (33%) in the cross-cylinder ablation group (mean speed 0.055 +/- 0.014 mm/h; P<.001).


CONCLUSIONS
Analysis of the data shows that epithelial migration along the photoablated corneal surface depends on the ablation pattern. The epithelial sliding is highly influenced by local variations in the curvature of the stromal surface. The data demonstrate that faster epithelial wound healing after PRK is predictive of optimal visual performance.
Serrao
Sebastiano
S
Serraolaser, Rome, Italy. info@serraolaser.it
Lombardo
Marco
M
D000328:Adult; D001251:Astigmatism / Q000601:surgery; D002465:Cell Movement / Q000502:physiology; D019781:Corneal Topography; D019573:Epithelium, Corneal / Q000502:physiology*; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D018903:Photorefractive Keratectomy; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology*