Mootha and colleagues1 are to be congratulated on their extensive study regarding the detection of prior laser-assisted in situ keratomileusis (LASIK) surgery in corneas being evaluated for possible transplantation. This issue is becoming more significant as the number of individuals undergoing laser vision correction dramatically increases each year. However, from the description of the methods, it appears that the fellowship-trained cornea investigator performing the slitlamp examination (SLE) on the donor corneas was aware of the prior LASIK procedures. Because the investigator was not blinded to the status of these corneas undergoing SLE, it suggests that the obvious flap edge found in 12 (46%) of 26 LASIK donor corneas is the only clinically relevant finding. The 10 of 26 LASIK donor corneas that had subtle flap edges by SLE might have been missed if the investigator had not known the status of prior refractive surgery.
Vavra DE, Enzenauer RW. Predictive Value of Slitlamp Examinations in Screening Donor Corneas for Prior Refractive Surgery. Arch Ophthalmol. 2005;123(5):707-708. doi:10.1001/archopht.123.5.707-c