Evaluation of the Corneal Structure with Confocal Microscopy in Eyes after Refractive Surgery during Ten-year Observation Period
Wydanie 1/2018
str. 11 – 20
Autorzy: Beata Bubała-Stachowicz 1 , Ewa Mrukwa-Kominek 1,2
1 Oddział Okulistyki Dorosłych Uniwersyteckiego Centrum Klinicznego im. prof. K. Gibińskiego Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Ewa Mrukwa-Kominek
2 Klinika Okulistyki Katedry Okulistyki Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Ewa Mrukwa-Kominek
Summary:
Purpose: The aim of the study was evaluation of the corneal structure in eyes after photorefractive keratectomy and laser-assisted in situ keratomileusis during ten-year observation period.
Methods: Patients were qualified for photorefractive keratectomy and laser-assisted in situ keratomileusis based on the subjective and objective examinations. The analysis included 100 eyes of 54 patients divided into two groups depending on the type of surgical treatment. Group I – 50 eyes which have undergone photorefractive keratectomy. Group II – 50 eyes after laser-assisted in situ keratomileusis. Confocal microscopic examination was carried out prior laser treatment to exclude patients with corneal structure abnormalities. It was then repeated at 3 months and 10 years after surgery to analyze and assess postoperative changes.
Results: Confocal microscopy revealed that changes in the corneal epithelium and stroma were the most pronounced during the first months after photorefractive keratectomy and laser-assisted in situ keratomileusis. In patients with low-to-moderate spherical myopia or myopic astigmatism, corneal structure stabilized promptly after both photorefractive keratectomy and laser-assisted in situ keratomileusis and did not show any subsequent alterations during a 10-year observation period. 10 years after surgery, patients with high-degree refractive errors still exhibited changes in the structure of the cornea, more pronounced after laser-assisted in situ keratomileusis. In groups I B and II B, a statistically significant correlation was revealed between corneal structure changes and corneal thickness over the entire observation period.
Conclusions: The examination of corneal structure using confocal microscopy revealed that, 10 years after surgery, patients who had presented with high-degree refractive errors still had changes in the corneal epithelium and stroma, the magnitude of which seemed to be associated with ablation depth during surgery. This observation concerns both patients after photorefractive keratectomy and laser-assisted in situ keratomileusis.