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Corneal Epithelial Healing After LASIK Surgery

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LASIK flap creation and stromal ablation elicit healing responses in the corneal ... This study is likely underpowered to determine the effects of smoking ... – PowerPoint PPT presentation

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Title: Corneal Epithelial Healing After LASIK Surgery


1
Corneal Epithelial Healing After LASIK Surgery
Category P5 Refractive
  • Yousuf Khalifa, MD
  • Tracie Sponseller, OD
  • David Bogorad, MD

2
Introduction
  • LASIK flap creation and stromal ablation elicit
    healing responses in the corneal epithelium and
    stroma
  • Physiology of corneal stroma healing after LASIK
    surgery has been described
  • Corneal epithelial wound healing after LASIK
    surgery has not been reported previously to our
    knowledge
  • Insights into the factors involved in corneal
    epithelium healing can be drawn from LASIK
    surgery

3
Methods
  • 65 consecutive LASIK surgery patients were
    included
  • LASIK flaps created with the Moria M2
    microkeratome, with Moria disposable heads, using
    published nomograms
  • Alcon Ladarvision 4000 platform used
  • Conventional, Custom, Myopic, and Hyperopic
    corrections included
  • Prednisolone Acetate 1 and Vigamox were
    prescribed tid along with Systane qid prn
  • Patients evaluated at postoperative day 1 with
    fluorescein staining to assess number of clock
    hours healed

4
Methods
  • Patient age, sex, treatment refraction,
    microkeratome suction ring and flap thickness,
    ablation depth, time of LASIK, elapsed time from
    surgery, number of stained clock hours entered
    into Excel spreadsheet
  • SAS version 9.1 was used for all analyses and
    statistical significance was assessed at the 5
    level

5
Results
6
Results
7
Results
A Bland-Altman plot illustrates that the majority
of the eyes within each subject are within the
limits of agreement. Thus, the measurement of
clock hours is in agreement for the two eyes
within each subject and that healing did not
differ between the eyes.
8
Results
9
Results
10
Results
11
Discussion
  • LASIK surgery is an ideal model to study human
    epithelial wound healing
  • Our results show that suction ring size, flap
    thickness, ablation depth have no correlation
    with epithelial healing
  • Fluorescein staining is a simple, safe,
    clinically accepted means of assessing epithelial
    integrity
  • Our study lays the foundation for future studies
    looking at factors that influence epithelial
    healing
  • Postoperative Day 1 is an excellent window to
    assess the epithelial healing because of the
    range of healed clock hours. In our study the
    elapsed time from surgery ranged from 16 to 26
    hours.

12
Discussion
  • OD and OS healing rates are consistent within
    each patient
  • Using the same blade on the OS after the OD does
    not affect epithelial healing
  • Between 16 and 26 hours after LASIK surgery the
    epithelial healing varies but the further out
    from surgery, the more likely to have more healed
    clock hours
  • Age did not closely correlate
  • Smoking status did not correlate
  • This study is likely underpowered to determine
    the effects of smoking
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