Document Detail


Mechanical Versus Alcohol-assisted Epithelial Debridement During Photorefractive Keratectomy: A Confocal Microscopic Clinical Trial.
MedLine Citation:
PMID:  21877678     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE:To compare the effects of mechanical versus alcohol-assisted epithelial debridement on corneal cellular elements after photorefractive keratectomy (PRK) using confocal microscopy. METHODS:This randomized, clinical trial included 66 eyes from 33 patients with spherical equivalent refraction <-4.00 diopters (D). Mechanical versus alcohol-assisted epithelial debridement was performed during PRK. The right eye of each patient was randomly assigned to one group (mechanical group or alcohol-assisted group) and the fellow eye to the alternate group. Confocal examination was performed preoperatively and at 3 and 6 months postoperatively. Main outcome measures were keratocyte density and maximum anterior stromal light reflectivity. RESULTS:Mean epithelial healing time was 3.2±0.4 and 3.0±0.3 days in the mechanical and alcohol-assisted groups, respectively (P=.001). Anterior retroablation stromal keratocyte density was 704.3±119.9 cells/mm(2) and 734.3±103.7 cells/mm(2) at 3 months (P=.05) and 643.8±134.4 cells/mm(2) and 696.7±129.6 cells/mm(2) at 6 months (P=.02) in the mechanical and alcohol-assisted groups, respectively. No significant difference was noted in midstromal and posterior keratocyte density between the two groups. Maximum reflectivity was 61.56±12.64 international units (IU) and 56.93±7.86 IU in the mechanical and alcohol-assisted groups, respectively, 3 months after surgery (P=.018). Corresponding values were 49.46±4.97 IU and 48.98±4.60 IU, respectively, 6 months after surgery (P=.628). CONCLUSIONS:Due to more adverse effects of mechanical epithelial debridement on anterior keratocyte density and anterior stromal reflectivity, alcohol-assisted epithelial debridement is recommended as the procedure of choice for epithelial removal during PRK in patients with mild myopia.
Authors:
Bahram Einollahi; Alireza Baradaran-Rafii; Mozhgan Rezaei-Kanavi; Medi Eslani; Mohammad-Reza Parchegani; Mohammad Zare; Sepehr Feizi; Farid Karimian
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-31
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  -     ISSN:  1081-597X     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-7     Citation Subset:  -    
Copyright Information:
Copyright 2011, SLACK Incorporated.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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