Abstract
Purpose. To use in vivo confocal microscopy to compare the wound-healing process in epikeratome laser-assisted in situ keratomileusis (epi-LASIK) with different management of the epithelial flaps. Methods. This prospective study comprised 46 eyes in the on-flap group and 47 eyes in the off-flap group. Epithelial flaps were repositioned or removed in the on- and off-flap eyes, respectively. In vivo confocal microscopy was performed before surgery and at 1 and 2 weeks and 1, 3, and 6 months after surgery. Corneal epithelial thickness, basal/apical surface epithelial morphology, and stromal reactions were analyzed. Results. Complete epithelialization by slit lamp biomicroscopy was faster for mitomycin C (MMC)-treated off-flap (4.27 ± 0.70 days) than on-flap (5.84 ± 0.08 days) eyes (P = 0.01). The percentage of eyes recovering to preoperative basal epithelial cell confocal morphology in the on- and off-flap groups was 87.5% and 92.3% for MMC-treated eyes and 86.3% and 90.5% in eyes without MMC treatment at 1 month after surgery. Of the studied eyes, with or without MMC, 50% and 100% returned to their preoperative apical epithelial morphology by 3 months in the on-flap and off-flap groups, respectively. Regression analysis revealed that the repositioned flap resulted in significant delay of epithelialization and apical-basal epithelial recovery (P <0.01). Stromal reaction did not differ significantly at any of the time points. Corneal epithelial thickness was significantly thicker in the on-flap eyes (54.2 ± 4.5 μm) than in the off-flap eyes (26.7 ± 5.8 μm) at 1 month after surgery (P <0.01). Conclusions. On- and off-flap epi-LASIK showed comparable clinical outcomes after surgery. Off-flap epi-LASIK had more rapid re-epithelialization and normalization of epithelial morphology than did on-flap epi-LASIK, when observed by in vivo confocal microscopy.
| Original language | English |
|---|---|
| Pages (from-to) | 3640-3647 |
| Number of pages | 8 |
| Journal | Investigative Ophthalmology and Visual Science |
| Volume | 52 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - May 2011 |
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ASJC Scopus subject areas
- Medicine(all)
- Ophthalmology
- Cellular and Molecular Neuroscience
- Sensory Systems
Cite this
Comparison of In Vivo Confocal Microscopic findings between epi-LASIK procedures with different management of the epithelial flaps. / Chen, Wei Li; Shen, Elizabeth P.; Hsieh, Yi Ting; Yeh, Po Ting; Wang, Tsung Jen; Hu, Fung Rong.
In: Investigative Ophthalmology and Visual Science, Vol. 52, No. 6, 05.2011, p. 3640-3647.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of In Vivo Confocal Microscopic findings between epi-LASIK procedures with different management of the epithelial flaps
AU - Chen, Wei Li
AU - Shen, Elizabeth P.
AU - Hsieh, Yi Ting
AU - Yeh, Po Ting
AU - Wang, Tsung Jen
AU - Hu, Fung Rong
PY - 2011/5
Y1 - 2011/5
N2 - Purpose. To use in vivo confocal microscopy to compare the wound-healing process in epikeratome laser-assisted in situ keratomileusis (epi-LASIK) with different management of the epithelial flaps. Methods. This prospective study comprised 46 eyes in the on-flap group and 47 eyes in the off-flap group. Epithelial flaps were repositioned or removed in the on- and off-flap eyes, respectively. In vivo confocal microscopy was performed before surgery and at 1 and 2 weeks and 1, 3, and 6 months after surgery. Corneal epithelial thickness, basal/apical surface epithelial morphology, and stromal reactions were analyzed. Results. Complete epithelialization by slit lamp biomicroscopy was faster for mitomycin C (MMC)-treated off-flap (4.27 ± 0.70 days) than on-flap (5.84 ± 0.08 days) eyes (P = 0.01). The percentage of eyes recovering to preoperative basal epithelial cell confocal morphology in the on- and off-flap groups was 87.5% and 92.3% for MMC-treated eyes and 86.3% and 90.5% in eyes without MMC treatment at 1 month after surgery. Of the studied eyes, with or without MMC, 50% and 100% returned to their preoperative apical epithelial morphology by 3 months in the on-flap and off-flap groups, respectively. Regression analysis revealed that the repositioned flap resulted in significant delay of epithelialization and apical-basal epithelial recovery (P <0.01). Stromal reaction did not differ significantly at any of the time points. Corneal epithelial thickness was significantly thicker in the on-flap eyes (54.2 ± 4.5 μm) than in the off-flap eyes (26.7 ± 5.8 μm) at 1 month after surgery (P <0.01). Conclusions. On- and off-flap epi-LASIK showed comparable clinical outcomes after surgery. Off-flap epi-LASIK had more rapid re-epithelialization and normalization of epithelial morphology than did on-flap epi-LASIK, when observed by in vivo confocal microscopy.
AB - Purpose. To use in vivo confocal microscopy to compare the wound-healing process in epikeratome laser-assisted in situ keratomileusis (epi-LASIK) with different management of the epithelial flaps. Methods. This prospective study comprised 46 eyes in the on-flap group and 47 eyes in the off-flap group. Epithelial flaps were repositioned or removed in the on- and off-flap eyes, respectively. In vivo confocal microscopy was performed before surgery and at 1 and 2 weeks and 1, 3, and 6 months after surgery. Corneal epithelial thickness, basal/apical surface epithelial morphology, and stromal reactions were analyzed. Results. Complete epithelialization by slit lamp biomicroscopy was faster for mitomycin C (MMC)-treated off-flap (4.27 ± 0.70 days) than on-flap (5.84 ± 0.08 days) eyes (P = 0.01). The percentage of eyes recovering to preoperative basal epithelial cell confocal morphology in the on- and off-flap groups was 87.5% and 92.3% for MMC-treated eyes and 86.3% and 90.5% in eyes without MMC treatment at 1 month after surgery. Of the studied eyes, with or without MMC, 50% and 100% returned to their preoperative apical epithelial morphology by 3 months in the on-flap and off-flap groups, respectively. Regression analysis revealed that the repositioned flap resulted in significant delay of epithelialization and apical-basal epithelial recovery (P <0.01). Stromal reaction did not differ significantly at any of the time points. Corneal epithelial thickness was significantly thicker in the on-flap eyes (54.2 ± 4.5 μm) than in the off-flap eyes (26.7 ± 5.8 μm) at 1 month after surgery (P <0.01). Conclusions. On- and off-flap epi-LASIK showed comparable clinical outcomes after surgery. Off-flap epi-LASIK had more rapid re-epithelialization and normalization of epithelial morphology than did on-flap epi-LASIK, when observed by in vivo confocal microscopy.
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U2 - 10.1167/iovs.10-6390
DO - 10.1167/iovs.10-6390
M3 - Article
VL - 52
SP - 3640
EP - 3647
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
SN - 0146-0404
IS - 6
ER -