Factors Associated with Incomplete Cleavage of the Corneal Epithelium in Alcohol-Assisted LASEK

PURPOSE: To evaluate the factors associated with unsuccessful cleavage of corneal epithelium in alcohol-assisted LASEK. METHODS: A total of 274 eyes in 137 patients who had received alcohol-assisted LASEK were enrolled in the present study. Associations of central corneal thickness, refractive error, pre-operative corneal curvature, ablation depth, anterior chamber volume and depth, and history of wearing contact lenses with epithelial cleavage were investigated. RESULTS: Complete epithelial cleavage was achieved in 198 eyes (72.3%) and incomplete epithelial cleavage in 76 eyes (27.7%). A history of wearing contact lenses (p = 0.018), continuous use of contact lenses (p = 0.034), longer use of contact lenses (p = 0.000), anterior chamber volume (p = 0.012) and depth (p = 0.012) were significantly associated with incomplete epithelial cleavage. CONCLUSIONS: Alcohol-assisted LASEK may cause problems in patients who experience continuous use of contact lenses and longer use of contact lenses. Patients with incomplete epithelial cleavage have small anterior chamber volume and shallow anterior chamber depth.

Central Toxic Keratopathy After LASEK

PURPOSE: We report a case of transient corneal opacity and hyperopia after LASEK surgery. CASE SUMMARY: A 21-year-old female visited our clinic complaining of decreased visual acuity in the left eye. The patient had undergone LASEK surgeryten days previously. Before LASEK surgery, the central corneal thickness of the left eye was 540 micrometer, and the refractive error was -2.00 Dsph=-0.75 Dcyl x80A with an estimated ablation depth of 52.2 micrometer. At the time of visit (on the tenth day after surgery), the best corrected visual acuity (BCVA) was 0.07, the central corneal thickness was 404 micrometer, and the refractive error was +1.00D=+1.25D x90. Slit-lamp biomicroscopy showed round central corneal haziness, but there were no signs of inflammation. At the third weeks after surgery, the central corneal thickness was 401 micrometer and the refractive error was +11.25D=-4.00D x145. Slit-lamp biomicroscopy showed sustained round central corneal haze. Twenty-two weeks after surgery, the central corneal thickness was 445 micrometer and the refractive error was -0.75D=-1.25D x180. The corneal opacity had disappeared. CONCLUSIONS: In case of transient corneal opacity, stromal loss and hyperopic change after LASEK surgery, central toxic keratopathy should be considered.

Erratum: Central Toxic Keratopathy after LASEK J Korean Ophthalmol Soc 2010;51(5):769-773, DOI:10.3341/jkos.2010.51.5.769

No abstract available.