Document Detail

Management of corneal epithelial defects following laser in situ keratomileusis.
MedLine Citation:
PMID:  11316020     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine the main principles of postoperative management in patients with epithelial defects following LASIK. METHODS: Patients with myopia and myopic astigmatism (N=2,972; refraction from -1.25 to -15.50 D) were treated with the Nidek EC-5000 excimer laser, using the Chiron Vision HT-230 Hansatome microkeratome. We observed 95 cases with intraoperative epithelial damage among 5,896 operations (1.6%) . Patients received traditional topical medical treatment (Tobramycin 0.3%, five times a day; Lacrisifi, six to eight times a day). In eyes with an epithelial defect less then 3 mm, no additional medical care was needed. In eyes with epithelial defects more then 3 mm, soft therapeutic contact lenses were used until total re-epithelialization occurred. RESULTS: Total re-epithelialization was observed the day following surgery in patients with small defects (less then 3 mm). Visual acuity achieved preoperative level 4 to 7 days after surgery. Total re-epithelialization in patients with soft contact lenses occurred 1 to 3 days after LASIK. On the next day examination, Solcoseryl 20% eye gel was added to topical therapy for corneal healing. In these patients visual acuity achieved preoperative level 10 to 14 days after surgery. In three eyes with large epithelial defects (4 to 5 mm), irregular astigmatism (one eye; 0.02%) or against-the-rule astigmatism (two eyes; 0.03%) occurred. Patients complained of blurred and double vision. Transepithelial phototherapeutic keratectomy was performed after 3 months for epithelial smoothing, with good visual results. CONCLUSION: Management of epithelial defects following LASIK can be concentrated on avoiding epithelial hyperplasia. Epithelial defects less than 3 mm do not appear to produce epithelial hyperplasia. Irregular astigmatism induced by LASIK can result in reduced best spectacle-corrected visual acuity. A common cause of irregular astigmatism is corneal epithelial remodeling and corneal thickening secondary to corneal epithelial defects created at the time of the LASIK procedure.
E Smirennaia; V Sheludchenko; N Kourenkova; O Kashnikova
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  17     ISSN:  1081-597X     ISO Abbreviation:  J Refract Surg     Publication Date:    2001 Mar-Apr
Date Detail:
Created Date:  2001-04-23     Completed Date:  2001-07-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S196-9     Citation Subset:  IM    
New Line Vision Medical Centre, Moscow, Russia.
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MeSH Terms
Astigmatism / surgery*
Contact Lenses
Corneal Diseases / diagnosis,  etiology,  therapy*
Corneal Topography
Epithelium, Corneal / pathology*
Keratomileusis, Laser In Situ / adverse effects*
Myopia / surgery*
Refraction, Ocular
Visual Acuity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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