Regression and epithelial hyperplasia after myopic photorefractive keratectomy in a human cornea

We present the histology of a cornea of a woman who had excimer laser photorefractive keratectomy (PRK) for myopia 6 months before she died in an accident. Preoperative spherical refraction was -6.00 diopters (D) with an astigmatism of -0.50 D. Six months postoperatively, refraction was -4.50 D. Slight corneal haze was noted at 1 and 3 months. The corneal histology showed marked epithelial hyperplasia in the center of the ablation zone without subepithelial deposition of newly synthesized collagen, proteoglycans, or both. The epithelial thickness was 38 microns in the untreated area and 93 microns in the center of the ablation. In conclusion, postoperative epithelial hyperplasia was responsible for regression after PRK in this eye.