Confocal microscopy changes in epithelial and stromal thickness up to 7 years after LASIK and photorefractive keratectomy for myopia.
OBJECTIVE
To determine the long-term changes in epithelial, stromal, and corneal thickness after LASIK and photorefractive keratectomy (PRK).


METHODS
In two prospective observational case series, 11 patients (16 eyes) received LASIK and 12 patients (18 eyes) received PRK to correct myopia or myopic astigmatism. None of the corneas had retreatment procedures. Corneas were examined using confocal microscopy before and at 1 month, and at 1, 2, 3, 5, and 7 years after surgery. Central thicknesses were measured from reflected light intensity profiles recorded by confocal microscopy. Postoperative epithelial thickness was compared to preoperative, and postoperative stromal and corneal thicknesses were compared to thickness at 1 month after surgery.


RESULTS
In LASIK, epithelial thickness at 1 month (51 +/- 4 microm, n = 11) was greater than before surgery (41 +/- 4 microm, n = 16; P < .001) and remained thicker through 7 years (52 +/- 6 microm, n = 13; P < .001). Stromal and corneal thickness did not change between 1 month and 7 years after LASIK. After PRK, corneal thickness at 1 year (464 +/- 44 microm, n = 17) was greater than at 1 month (442 +/- 39 microm, n = 15; P = .001) and remained thicker at 7 years after PRK (471 +/- 45 microm, n = 17; P > .001).


CONCLUSIONS
The early increase in central epithelial thickness after myopic LASIK persists for at least 7 years and is probably the result of epithelial hyperplasia. Central corneal thickness increases during the first year after PRK and remains stable thereafter up to 7 years.
Patel
Sanjay V
SV
Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minn., USA. patel.sanjay@mayo.edu
Erie
Jay C
JC
McLaren
Jay W
JW
Bourne
William M
WM
D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D003315:Cornea / Q000473:pathology; D003319:Corneal Stroma / Q000473:pathology*; D019573:Epithelium, Corneal / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D018613:Microscopy, Confocal; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D013997:Time Factors