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August 1996

Central and Peripheral Endothelial Cell Changes After Excimer Laser Photorefractive Keratectomy for Myopia

Author Affiliations

From the Department of Ophthalmology and Visual Sciences, School of Medicine, The University of Texas Medical Branch, (Drs Trocmé, Gill, Gold, and Milstein and Mr Mack) and the Moody Ophthalmic Laser Center, St Mary's Hospital (Drs Trocmé, Gold, and Milstein), Galveston, Tex; and the Department of Ophthalmology, Mayo Clinic, Rochester, Minn (Dr Bourne).

Arch Ophthalmol. 1996;114(8):925-928. doi:10.1001/archopht.1996.01100140133003

Objective:  To investigate changes in the human corneal endothelium after photorefractive keratectomy for treatment of myopia.

Design:  Specular microscopy of the central, paracentral, and peripheral zones of the corneas of 14 patients (12 of whom were previous contact lens wearers) was performed preoperatively and at 1, 2,3,6, and 12 months after photorefractive keratectomy. The corneal endothelial cell density, coefficient of variation (CV) of the endothelial cell area, and percentage of hexagonal cells were assessed at each examination.

Results:  The central endothelial cell density was increased by 7% during the first 3 postoperative months (P<.05). In contrast, the peripheral cell density declined steadily by 6.9% during the first year (P<.01). The CV of the cell area was decreased in all 3 zones, whereas the percentage of hexagonal cells was increased in the central and paracentral zones (P<.05).

Conclusions:  We observed statistically significant changes in the central and peripheral endothelial cell densities and morphological features that could have resulted from photorefractive keratectomy; however, these changes also may have been explained by the discontinuation of contact lens wear. If such changes are contact lens-related, they could mask the effects of laser-induced damage to the central zone of the endothelium.

Gartry DS, Kerr-Muir MG, Marshall J.  Excimer laser photorefractive keratectomy: 18 month follow-up . Ophthalmology . 1992;99:1209-1219.Article
Salz JJ, Maguen E, Nesburn AB, et al.  A two-year experience with excimer laser photorefractive keratectomy for myopia . Ophthalmology . 1993;100:873-882.Article
Eiferman RA, O'Neill KP, Forgey DR, Cook YD.  Excimer laser photorefractive keratectomy for myopia: six month results . Refract Corneal Surg . 1991;7:344-347.
Tengroth B, Epstein D, Fagerholm P, Hamberg-Nystrom H, Fitzsimmons TD.  Excimer laser photorefractive keratectomy for myopia: clinical results in sighted eyes . Ophthalmology . 1993;100:739-745.Article
McDonald MB, Liu JC, Byrd TJ, et al.  Central photorefractive keratectomy for myopia: partially sighted and normally sighted eyes . Ophthalmology . 1991;98:1327-1337.Article
McDonald MB, Frantz JM, Klyce SD, et al.  Central photorefractive keratectomy for myopia: the blind eye study . Arch Ophthalmol . 1990;108:799-808.Article
Wilson SE, Klyce SD, McDonald MB, Liu JC, Kaufman HE.  Changes in corneal topography after excimer laser photorefractive keratectomy for myopia . Ophthalmology . 1991;98:1338-1347.Article
Maguire LJ, Zabel RW, Parker P, Lindstrom RL.  Topography and raytracing analysis of patients with excellent visual acuity 3 months after excimer laser photorefractive keratectomy for myopia . Refract Corneal Surg . 1991;7:122-128.
Hanna KD, Pouliquen Y, Waring GO III, et al.  Corneal stromal wound healing in rabbits after 193-nm excimer laser surface ablation . Arch Ophthalmol . 1989;107:895-901.Article
Dehm EJ, Puliafito CA, Alder CM, Steinert RF.  Corneal endothelial injury in rabbits following excimer laser ablation at 193 and 248 nm . Arch Ophthalmol . 1986;104:1364-1368.Article
Marshall J, Trokel S, 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.Article
Berns MW, Liaw LH, Oliva A, Andrews JJ, Rasmussen RE, Kimel S.  An acute light and electron microscopic study of ultraviolet 193-nm excimer laser corneal incisions . Ophthalmology . 1988;95:1422-1433.Article
Gaster RN, Binder PS, Coalwell K, Berns M, McCord RC, Burstein NL.  Corneal surface ablation by 193 nm excimer laser and wound healing in rabbits . Invest Ophthalmol Vis Sci . 1989;30:90-98.
Sher NA, Chen V, Bowers RA, et al.  The use of 193-nm excimer laser for myopic photorefractive keratectomy in sighted eyes: a multicenter study . Arch Ophthalmol . 1991;109:1525-1530.Article
Amano S, Shimizu K.  Corneal endothelial changes after excimer laser photorefractive keratectomy . Am J Ophthalmol . 1993;116:692-694.
Carones F, Brancato R, Venturi E, Morico A.  The corneal endothelium after myopic excimer laser photorefractive keratectomy . Arch Ophthalmol . 1994;112:920-924.Article
Sher NA, Bowers RA, Zabel RW, et al.  Clinical use of the 193-nm excimer laser in the treatment of corneal scars . Arch Ophthalmol . 1991;109:491-498.Article
Stulting RD, Thompson KP, Lynn MJ.  The effect of excimer laser photorefractive keratectomy (PRK) on the human corneal endothelium . Invest Ophthalmol Vis Sci . 1995;36:S1062. ARVO abstract.
Bourne WM, Enoch JM.  Some optical principles of the clinical specular microscope . Invest Ophthalmol . 1976;15:29-32.
Yashima Y, McAuliffe DJ, Flotte TJ.  Cell selectivity to laser-induced photoacoustic injury of skin . Lasers Surg Med . 1990;10:280-283.Article
Yashima Y, McAuliffe DJ, Jacques SL, Flotte TJ.  Laser-induced photoacoustic injury of skin: effect of intertial confinement . Lasers Surg Med . 1991;11:62-68.Article
Carlson KH, Bourne WM, Brubaker RF,  Effects of long-term contact lens wear on corneal endothelial cell morphology and function . Invest Ophthalmol Vis Sci . 1988;29:185-193.
Sibug ME, Datiles MB, Kashima K, McCain L, Kracher G.  Specular microscopy studies on the corneal endothelium after cessation of contact lens wear . Cornea . 1991;10:395-401.Article
MacRae SM, Matsuda M, Phillips DS.  The long-term effects of polymethyl-methacrylate contact lens wear on the corneal endothelium . Ophthalmology . 1994;101:365-370.Article