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Corneal Healing Following Laser Refractive Keratectomy FREE

Gerri L. Goodman, MD; Stephen L. Trokel, MD; Walter J. Stark, MD; Charles R. Munnerlyn, PhD; W. Richard Green, MD
[+] Author Affiliations

Accepted for publication July 20, 1989.

Reprint requests to The Wilmer Institute, The Johns Hopkins Hospital, Maumenee Bldg 327,600 N Wolfe St, Baltimore, MD 21205 (Dr Stark).


Arch Ophthalmol. 1989;107(12):1799-1803. doi:10.1001/archopht.1989.01070020881031
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• A 193-nm excimer laser system was used to ablate 4.5-mm optically contoured zones in the corneal stroma of rabbits to achieve optical flattening of 2, 4, 8, and 16 diopters. We studied the effect of edge profile and wound depth on reepithelialization and stromal remodeling using dichlorotriazinyl aminofluorescein, a vital dye that covalently binds to the stromal bed and delineates the boundaries of new collagen synthesis. All the corneas reepithelialized; no subsequent recurrent erosions occurred. All seven corneas that received an ablation of less than 50 μm were clear centrally at 8 weeks. At an ablation depth of approximately 100 μm, opacification and scarring were observed biomicroscopically and histopathologically in two specimens. No evidence of new collagen formation or epithelial hyperplasia was found in any of the seven corneas that remained clear. Stromal remodeling was observed in the two corneas that exhibited scarring.

REFERENCES

Trokel SL, Srinivasan R, Braren B.  Excimer laser surgery of the cornea . Am J Ophthalmol . 1983;;96:710-715.
Krueger RR, Trokel SL.  Quantitation of corneal ablation by ultraviolet laser light . Arch Ophthalmol . 1985;;103:1741-1742.
Tuft S, Marshall J, Rothery S.  Stromal remodeling following photorefractive keratectomy . Lasers Ophthalmol . 1987;;1:177-183.
Tuft SJ, Zabel RW, Marshall J. Corneal repair following keratectomy: a comparison between conventional surgery and laser photablation. Invest Ophthalmol Vis Sci. In press.
Davison PF, Galbavy EJ.  Fluorescent dyes demonstrate the uniform expansion of the growing rabbit cornea . Invest Ophthalmol Vis Sci . 1985;;26:1202-1209.
Davison PF, Galbavy EJ.  Connective tissue remodeling in corneal and scleral wounds . Invest Ophthalmol Vis Sci . 1986;;27:1478-1484.
Marshall J, Trokel SL, Rothery S, Krueger RR.  Photablative reprofiling of the cornea using an excimer laser: photorefractive keratectomy . Lasers Ophthalmol . 1987;;1:21-48.
Munnerlyn CR, Koons SJ, Marshall J.  Photorefractive keratectomy: a technique for laser refractive surgery . J Cataract Refract Surg . 1988;;14:46-52.
Kerr-Muir MG, Trokel SL, Marshall J, Rothery S.  Ultrastructural comparison of conventional surgical and argon fluoride excimer laser keratectomy . Am J Ophthalmol . 1987;;103:448-453.
McDonald MB, Beuerman R, Falzoni W, Rivera L, Kaufman HE.  Refractive surgery with the excimer laser . Am J Ophthalmol . 1987;;103:469-471.
Marshall J, Trokel SL, Rothery S, Schubert H.  An ultrastructural study of corneal incisions induced by an excimer laser at 193 nm . Ophthalmology . 1985;;92:749-758.
Marshall J, Trokel SL, Rothery S, Krueger RR.  A comparative study of corneal incisions induced by diamond and steel knives and two ultraviolet radiations from an excimer laser . Br J Ophthalmol . 1986;;70:482-501.
Marshall J, Trokel SL, Rothery S, Krueger RR.  Long-term healing of the central cornea after photorefractive keratectomy using an excimer laser . Ophthalmology . 1988;;95:1411-1421.
Hanna KD, Pouliquen Y, Waring GO, et al.  Corneal stromal wound healing in rabbits after 193-nm excimer laser surface ablation . Arch Ophthalmol . 1989;;107:895-901.

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Trokel SL, Srinivasan R, Braren B.  Excimer laser surgery of the cornea . Am J Ophthalmol . 1983;;96:710-715.
Krueger RR, Trokel SL.  Quantitation of corneal ablation by ultraviolet laser light . Arch Ophthalmol . 1985;;103:1741-1742.
Tuft S, Marshall J, Rothery S.  Stromal remodeling following photorefractive keratectomy . Lasers Ophthalmol . 1987;;1:177-183.
Tuft SJ, Zabel RW, Marshall J. Corneal repair following keratectomy: a comparison between conventional surgery and laser photablation. Invest Ophthalmol Vis Sci. In press.
Davison PF, Galbavy EJ.  Fluorescent dyes demonstrate the uniform expansion of the growing rabbit cornea . Invest Ophthalmol Vis Sci . 1985;;26:1202-1209.
Davison PF, Galbavy EJ.  Connective tissue remodeling in corneal and scleral wounds . Invest Ophthalmol Vis Sci . 1986;;27:1478-1484.
Marshall J, Trokel SL, Rothery S, Krueger RR.  Photablative reprofiling of the cornea using an excimer laser: photorefractive keratectomy . Lasers Ophthalmol . 1987;;1:21-48.
Munnerlyn CR, Koons SJ, Marshall J.  Photorefractive keratectomy: a technique for laser refractive surgery . J Cataract Refract Surg . 1988;;14:46-52.
Kerr-Muir MG, Trokel SL, Marshall J, Rothery S.  Ultrastructural comparison of conventional surgical and argon fluoride excimer laser keratectomy . Am J Ophthalmol . 1987;;103:448-453.
McDonald MB, Beuerman R, Falzoni W, Rivera L, Kaufman HE.  Refractive surgery with the excimer laser . Am J Ophthalmol . 1987;;103:469-471.
Marshall J, Trokel SL, Rothery S, Schubert H.  An ultrastructural study of corneal incisions induced by an excimer laser at 193 nm . Ophthalmology . 1985;;92:749-758.
Marshall J, Trokel SL, Rothery S, Krueger RR.  A comparative study of corneal incisions induced by diamond and steel knives and two ultraviolet radiations from an excimer laser . Br J Ophthalmol . 1986;;70:482-501.
Marshall J, Trokel SL, Rothery S, Krueger RR.  Long-term healing of the central cornea after photorefractive keratectomy using an excimer laser . Ophthalmology . 1988;;95:1411-1421.
Hanna KD, Pouliquen Y, Waring GO, et al.  Corneal stromal wound healing in rabbits after 193-nm excimer laser surface ablation . Arch Ophthalmol . 1989;;107:895-901.

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