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Corneal recovery after LASIK for high myopia A 2-year prospective confocal microscopic study
  1. Jukka A Moilanen (jukka.moilanen{at}hus.fi),
  2. Juha M Holopainen (juha.holopainen{at}hus.fi),
  3. Minna H Vesaluoma (minna.vesaluoma{at}hus.fi),
  4. Timo M Tervo (timo.tervo{at}hus.fi)
  1. Helsinki University Central Hospital, Department of Ophthalmology, Helsinki, Finland
  2. University of Helsinki, Finland
  3. University of Helsinki, Finland
  4. Helsinkin Univ Eye Hospital, Finland

    Abstract

    Aim: To quantify human corneal recovery after moderate to high myopic laser in situ keratomileusis (LASIK) in a two year prospective follow-up study.

    Methods: Fifteen eyes of 15 patients (mean refraction -10.1 ± 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. 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 five days after LASIK. A gradual increase was observed from two weeks postoperatively, but even 2 years after the operation the nerve density was only 64 % from the preoperative values.

    Conclusions: Subbasal nerve fiber density shows a gradual recovery throughout the follow-up. However, only three subjects showed totally regenerated subbasal nerve fibers 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.

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