Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom
Introduction: Laser Subepithelial Keratomileusis (LASEK) is a type of surface ablation laser surgery that offers a solution to patients for correcting their ametropia. In rare instances, LASEK has been associated with complications such as the development of postoperative haze, infection, and po...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/19225/68831_CE[Ra1]_F(SS)_QC(SHK_IS)_Ref_Pat(RDW_OM)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
| Summary: | Introduction: Laser Subepithelial Keratomileusis (LASEK) is
a type of surface ablation laser surgery that offers a solution
to patients for correcting their ametropia. In rare instances,
LASEK has been associated with complications such as the
development of postoperative haze, infection, and poor visual
outcomes. Imaging features detected within the patient’s
cornea using In-Vivo Confocal Microscopy (IVCM) have aided in
identifying the cellular basis of complications like these.
Aim: To observe and describe the morphological changes seen
on IVCM in patients following LASEK surgery.
Materials and Methods: This observational study aimed to
assess the quantity and morphology of anterior and posterior
keratocytes in adults aged 18 years and older. Five participants
(9 eyes) who presented for follow-up appointments following
LASEK surgery at Manchester Royal Eye Hospital (MREH),
United Kingdom, from July to December 2018 were recruited
for the study. The cell counts of the anterior and posterior
keratocytes were calculated using the Heidelberg Eye Explorer
software. The images were analysed with the Image J program
(National Institutes of Health, Bethesda, USA). Nerve fibers
were assessed using the ACCMetrics program (University of
Manchester, UK). The t-test was used to establish the statistical
association between variables.
Results: Morphological changes, such as zones of hyperreflectivity
beneath the epithelium, were observed in all the
recruited participants. Immune cells and sub-basal nerve
abnormalities were detected in several participants. The number
of keratocytes in the anterior stroma of all the participants was
found to be much lower compared to that of the control. Only
participant number 3 had a greater number of keratocytes in the
anterior stromal layer (454 and 514 cells/mm2) compared to the
other participants, who had a cell count ranging between 156
to 262 cells/mm2.
Conclusion: It is evident that visible changes are noted both
quantitatively and morphologically in both the anterior and
posterior keratocytes postoperatively. More research is required
with larger controlled studies to investigate the IVCM imaging
biomarkers and morphological features that represent the wound
healing process and the factors influencing visual outcomes,
ensuring that postoperative complications can be minimised. |
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| ISSN: | 2249-782X 0973-709X |