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...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2024-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| 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 |
| _version_ | 1797255045057609728 |
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| author | Daphné Gunness Indrajit Banerjee Jared Robinson Teeluck Kumar Gunness |
| author_facet | Daphné Gunness Indrajit Banerjee Jared Robinson Teeluck Kumar Gunness |
| author_sort | Daphné Gunness |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T21:59:36Z |
| format | Article |
| id | doaj.art-024ff398e1114207837021c20ce2527c |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-24T21:59:36Z |
| publishDate | 2024-04-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-024ff398e1114207837021c20ce2527c2024-03-20T11:50:18ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2024-04-011804041010.7860/JCDR/2024/68831.19225Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United KingdomDaphné Gunness0Indrajit Banerjee1Jared Robinson2Teeluck Kumar Gunness3Junior Clinical Fellow, Department of Ophthalmology, Wrexham Maelor Hospital, Wales, United Kingdom.Professor, Department of Pharmacology, Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius.Junior Doctor, Department of Medicine, Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius.Director, Department of Cardiology, Cardiac Centre, Sir Seewoosagur Ramgoolam National Hospital (SSRN), Pamplemousses, Mauritius.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.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).pdflaser therapyoperativeophthalmologic surgical proceduresrefractive errorsrefractive surgical procedures |
| spellingShingle | Daphné Gunness Indrajit Banerjee Jared Robinson Teeluck Kumar Gunness Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom Journal of Clinical and Diagnostic Research laser therapy operative ophthalmologic surgical procedures refractive errors refractive surgical procedures |
| title | Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom |
| title_full | Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom |
| title_fullStr | Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom |
| title_full_unstemmed | Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom |
| title_short | Morphological Changes of Corneal Keratocytes following Surface Ablation Laser Surgery: An Observational Study from the United Kingdom |
| title_sort | morphological changes of corneal keratocytes following surface ablation laser surgery an observational study from the united kingdom |
| topic | laser therapy operative ophthalmologic surgical procedures refractive errors refractive surgical procedures |
| url | 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 |
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