title: Assessment of epithelial integrity and cell viability in epithelial flaps prepared with the epi-LASIK procedure.
abstract: OBJECTIVE
  To assess the histological integrity and cell viability in epithelial flaps prepared with epikeratomes.
  
  
  METHODS
  Department of Ophthalmology, Kyoto Prefectural University of Medicine and The Baptist Eye Clinic, Kyoto, Japan.
  
  
  METHODS
  Epithelial flaps were prepared by epi-LASIK surgery. After immediate fixation, they were examined by light and electron microscopy. To assess cell viability in fresh epithelial flaps, biostaining experiments were performed using propidium iodide (PI), calcein-AM, and Hoechst 33342 dye. In addition, some epithelial flaps were organ-cultured for 24 hours.
  
  
  RESULTS
  Light and electron microscopy showed that most of the inspected areas showed nuclei and cytoplasm at significantly reduced density and discontinuity of the basement membrane. Biostaining experiments showed that approximately 90% of the basal cells in epithelial flaps were PI-positive dead cells; organ cultures showed detachment of basal cells from the epithelial flap after 24 hours of incubation.
  
  
  CONCLUSIONS
  Most basal cells in epithelial flaps prepared with different epikeratome devices were dead.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, and The Baptist Eye Clinic, Kyoto, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Tanioka
authors.forename: Osamu
authors.initials: O
authors.lastname: Hieda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawasaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D001562:Benzimidazoles / Q000378:metabolism; D002470:Cell Survival; D004396:Coloring Agents / Q000378:metabolism; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology* / Q000648:ultrastructure; D019573:Epithelium, Corneal / Q000378:metabolism / Q000473:pathology* / Q000648:ultrastructure; D005452:Fluoresceins / Q000378:metabolism; D005456:Fluorescent Dyes / Q000378:metabolism; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D018613:Microscopy, Confocal; D009216:Myopia / Q000601:surgery; D009924:Organ Culture Techniques; D011419:Propidium / Q000378:metabolism; D013194:Staining and Labeling / Q000379:methods; D013524:Surgical Flaps / Q000473:pathology*
chemical_list: D001562:Benzimidazoles; D004396:Coloring Agents; D005452:Fluoresceins; D005456:Fluorescent Dyes; C085925:calcein AM; D011419:Propidium; C017807:bisbenzimide ethoxide trihydrochloride