Confocal Microscopic Findings Associated with LASIK Flap with Foreign Corneal Epithelial Cells

Kim, Jae Sam; Hong, Jong Wook; Lee, Jong Soo

Abstract

PURPOSE: To evaluate the inflammatory response following the insertion of corneal epithelium into rabbit corneal stroma using confocal microscope.
METHODS
Newzealand white rabbits were underwent corneal flap procedure using Microkeratome (Hansatome, Chiron, USA) and corneal epithelium was inserted. We divided the rabbits into three groups: Group A: flap only, Group B: flap with central epithelium insertion, Group C: flap with peripheral epithelium insertion. We examined the rabbit corneas at the time point of 4, 24, 72hours, 7days, and 1 month after surgery using confocal microscope and CD 11b immunohistochemical stain.
RESULTS
At the early stage, the inflammatory cells were more frequently observed in the group C than in the group A and B, and at postoperative 72hours only in the group C. In stromal and total corneal thickness, there was a tendency of increase to the postoperative 24 hours and decrease in all groups, but the group C was more stronger tendency than other groups (P<0.05). There is no significant difference of the flap thickness among three groups (P>0.05). In immunohistochemical staining (CD11b), polynucleated cells and mast cells were more visible in group B and C than in group A.
CONCLUSIONS
The postoperative inflammatory reaction of the LASIK flap may be related with corneal epithelial cells, and we think that more attention should be needed with the management of microkeratome.