An Ultrastructural and Histochemical Study of Long-Term Wound Healing after Radial Keratotomy

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Using correlative microscopy and plant lectins conjugated to fluorescent dyes, we studied two human corneal specimens obtained 66 and 70 months after radial keratotomy. In one case a second radial keratotomy had been performed 11 months before we obtained the corneal specimen, which allowed us to compare wounds 11 and 66 months old in the same specimen. The 11-month-old incisions demonstrated morphologic features consistent with incomplete wound healing, whereas the incisions examined 66 and 70 months postoperatively demonstrated complete wound healing. A different lectin binding pattern of wheat germ agglutinin and concanavalin-A was observed in the 11-month-old wounds, compared with the 66-month-old wounds. Published and unpublished morphologic studies of 17 human keratotomy specimens have demonstrated incomplete wound healing up to 47 months postoperatively. The present study documents complete corneal wound healing 66 months after radial keratotomy.

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Reprint requests to Perry S. Binder, M.D., Eye Care of La Jolla, 9834 Genesee Ave., Suite 200, La Jolla, CA 92037.

This study was sponsored in part by Public Health Service grant EY04557 from the National Eye Institute, National Institutes of Health, and a grant from the San Diego Eye Foundation.a

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