American Journal of Ophthalmology
Volume 141, Issue 5 , Pages 799-809.e1, May 2006

Corneal Keratocyte Deficits After Photorefractive Keratectomy and Laser In Situ Keratomileusis

  • Jay C. Erie, MD

      Affiliations

    • Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    • Corresponding Author InformationInquiries to Jay C. Erie, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905
    • ,
  • Sanjay V. Patel, MD

      Affiliations

    • Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    • ,
  • Jay W. McLaren, PhD

      Affiliations

    • Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    • ,
  • David O. Hodge, MS

      Affiliations

    • Division of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
    • ,
  • William M. Bourne, MD

      Affiliations

    • Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

Accepted 5 December 2005. published online 13 February 2006.

Purpose

To measure changes in keratocyte density up to five years after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK).

Design

Prospective, nonrandomized clinical trial.

Methods

Eighteen eyes of 12 patients received PRK to correct a mean refractive error of −3.73 ± 1.30 diopters, and 17 eyes of 11 patients received LASIK to correct a mean refractive error of −6.56 ± 2.44 diopters. Corneas were examined by using confocal microscopy before and six months, one year, two years, three years, and five years after the procedures. Keratocyte densities were determined in five stromal layers in PRK patients and in six stromal layers in LASIK patients. Differences between preoperative and postoperative cell densities were compared by using paired t tests with Bonferroni correction for five comparisons.

Results

After PRK, keratocyte density in the anterior stroma decreased by 40%, 42%, 45%, and 47% at six months, two years, three years, and five years, respectively (P < .001). At five years, keratocyte density decreased by 20% to 24% in the posterior stroma (P < .05). After LASIK, keratocyte density in the stromal flap decreased by 22% at six months (P < .02) and 37% at five years (P < .001). Keratocyte density in the anterior retroablation zone decreased by 18% (P < .001) at one year and 42% (P < .001) at five years. At five years, keratocyte density decreased by 19% to 22% (P < .05) in the posterior stroma.

Conclusions

Keratocyte density decreases for at least five years in the anterior stroma after PRK and in the stromal flap and the retroablation zone after LASIK.

 

 See accompanying Editorial on page 918.This study was supported in part by grant EY 02037 from the National Institutes of Health, Bethesda, Maryland; Research to Prevent Blindness, Inc, New York, New York; and the Mayo Foundation, Rochester, Minnesota.Data from this study were presented in part at the Annual Meeting of the American Ophthalmological Society, Sea Island, Georgia, May 24, 2005.

PII: S0002-9394(05)01299-7

doi:10.1016/j.ajo.2005.12.014

Refers to article:

  • Long-Term Corneal Keratocyte Deficits After PRK and LASIK: In Vivo Evidence of Stress-Induced Premature Cellular Senescence , 21 February 2006

    Daniel G. Dawson, Terrence P. O’Brien, Henry F. Edelhauser
    American Journal of Ophthalmology May 2006 (Vol. 141, Issue 5, Pages 918-920)

American Journal of Ophthalmology
Volume 141, Issue 5 , Pages 799-809.e1, May 2006

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