ABSTRACT
PURPOSE: To evaluate the efficacy of autologous serum eye drops for dry eye after LASIK in a prospective, randomized study. METHODS: Fifty-four eyes of 27 male patients who underwent LASIK were divided into two groups; patients who used autologous serum eye drops and those who used artificial tears postoperatively. Schirmer test with anesthesia, tear break-up time (BUT), and rose bengal and fluorescein staining for the ocular surface were prospectively compared between the groups. All values were also compared before and after surgery (at 1 week [except for Schirmer test], 1 month, 3 months, and 6 months) in each group. RESULTS: Tear BUT was greater in the autologous serum eye drops group than in the artificial tears group at 6 months postoperatively. Rose bengal score was lower in patients using autologous serum eye drops than in patients using artificial tears at 1 month and 3 months postoperatively. No significant difference was noted between patients using autologous serum eye drops and patients using artificial tears in the value of Schirmer test with anesthesia and fluorescein scores. In the autologous serum eye drops group, tear BUT was increased at 3 months after LASIK, rose bengal score was lower at 1 month and 3 months, and fluorescein score was lower at 1 month after LASIK compared to preoperative values, respectively. In the artificial tears group, all values (Schirmer test, tear BUT, rose bengal score, and fluorescein score) showed no differences between before and after LASIK. No differences were noted in the subjective scores for dryness between the autologous serum eye drops and artificial tears groups. CONCLUSIONS: The autologous serum eye drops group showed prolongation of the tear BUT and a reduction in rose bengal staining score.
Subject(s)
Blood Proteins/administration & dosage , Dry Eye Syndromes/drug therapy , Keratomileusis, Laser In Situ/adverse effects , Serum , Adult , Dry Eye Syndromes/diagnosis , Fluorescein , Fluorescent Dyes , Follow-Up Studies , Humans , Male , Myopia/surgery , Ophthalmic Solutions/administration & dosage , Postoperative Complications , Prospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To investigate the risk factors and mechanisms of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK). METHODS: In 5708 eyes of 2927 patients who underwent LASIK, the patient's background, clinical findings, and surgical data were retrospectively evaluated and compared with patients who had DLK and those who did not (non-DLK group). RESULTS: DLK occurred in 46 of 5708 eyes (0.81%). DLK occurred more frequently in eyes operated with the MK-2000 microkeratome (1.1%) than with the LSK-One microkeratome (0.6%; P = .039). Corneal endothelial cell density (2686.8 +/- 235.3/mm2) was significantly lower in eyes that developed DLK than in eyes without DLK (2783.8 +/- 275.5/mm2; P = .017). The width of palpebral fissure in a normal state and the maximum opening position were significantly larger in the DLK group (10.3 +/- 1.9 mm and 18.1 +/- 7.2 mm, respectively) than the non-DLK group (8.3 +/- 1.6 mm with P < .001; 11.5 +/- 2.0 mm with P = .012). CONCLUSIONS: The type of microkeratome, lower corneal endothelial cell density, and larger palpebral fissure were potential risk factors for DLK after LASIK. These factors may be associated with delayed wound healing of the corneal flap margin, resulting in poor sealing of the flap, which may induce the influx of inflammatory cells.
Subject(s)
Keratitis/etiology , Keratomileusis, Laser In Situ/adverse effects , Postoperative Complications , Adult , Cell Count , Endothelium, Corneal/pathology , Female , Humans , Male , Retrospective Studies , Risk Factors , Wound HealingABSTRACT
PURPOSE: To investigate the cell populations in diffuse lamellar keratitis (DLK) infiltration after laser in situ keratomileusis and the possible mechanism underlying the infiltration. SETTING: Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. METHODS: To develop DLK in rabbit eyes, 25 microL of lipopolysaccharide (LPS) solution at a concentration of 50 microg/mL was applied to the stromal bed beneath corneal flaps. For control rabbits, phosphate-buffered saline was applied. Postoperative examination by slitlamp microscopy was performed for 3 days after surgery. Rabbit eyes were excised and examined for histopathology with hematoxylin and eosin staining. Immunohistochemical analysis for interleukin (IL)-8 was performed. RESULTS: Diffuse lamellar keratitis-like inflammation composed mainly of neutrophils was reproduced by LPS instillation in rabbit eyes. In eyes with severe inflammation, IL-8 immunoreactivity was found in the stromal keratocytes and infiltrating neutrophils. CONCLUSIONS: The major cell type in the DLK infiltration induced by LPS instillation in rabbit eyes was the neutrophil. Interleukin-8, a prototype of CXC chemokine produced by keratocytes and neutrophils, may contribute to the development of DLK.
