Corneal recovery after lasik for high myopia: a 2-year prospective confocal microscopic study
- 1Helsinki University Central Hospital, Department of Ophthalmology, Helsinki, Finland
- 2Centre for Military Medicine, Aero Medical Centre, Helsinki, Finland
- Dr J Moilanen, Centre for Military Medicine, Aero Medical Centre, Helsinki, Finland;
- Accepted 20 June 2008
- Published Online First 23 July 2008
Aim: To quantify human corneal recovery after moderate to high myopic laser in situ keratomileusis (LASIK) in a 2-year prospective follow-up study.
Methods: Fifteen eyes of 15 patients (mean refraction −10.1 (SD 2.4) D) were examined preoperatively and postoperatively at day 1, 5 days, 2 weeks, 1, 3 and 6 months and 2 years. Biomicroscopy, visual acuity and refraction were examined prior to imaging studies. An in vivo tandem scanning confocal microscope was used to obtain images from the central cornea. Subbasal nerve density was measured as the total length of nerve trunks in confocal image per mm2. Keratocyte density was calculated manually from stromal sublayers. The thickness of the altered keratocyte zone was measured on both sides of the LASIK interface.
Results: At the end of the follow-up, all patients had a 20/20 BCVA, and nine of 15 patients were within ±0.5 D of the intended correction. The total corneal thickness remained unaltered, but epithelial hyperplasia was seen at 2 years. Keratocyte density in the anterior stroma and posterior to the flap interface showed a slight decrease during the follow-up. Subbasal nerve density decreased 82% in 5 days after LASIK. A gradual increase was observed from 2 weeks postoperatively, but even 2 years after the operation the nerve density was only 64% from the preoperative values.
Conclusions: Subbasal nerve fibre density shows a gradual recovery throughout the follow-up. However, only three subjects showed totally regenerated subbasal nerve fibres at 2 years. This may correlate with the observed decrease in the density of the most anterior keratocytes. Corneal remodelling seemed to continue for at least 2 years.
Funding: Supported in part by Grants from The Finnish Eye Foundation, Helsinki, Finland; The Eye and Tissue Bank Foundation, Helsinki, Finland; Evald and Hilda Nissi Foundation, Espoo, Finland; Friends of the Blind, Helsinki, Finland; and The Helsinki University Central Hospital Research Fund, Helsinki, Finland.
Competing interests: None.
Ethics approval: The Ethical committee of the Helsinki University Central Hospital approved the study protocol.
Patient consent: Obtained.