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Related Experiment Videos

Corneal surface after deepithelialization using a sharp and a dull instrument.

M Campos1, L Hertzog, X W Wang

  • 1Doheny Eye Institute, Los Angeles, CA 90033.

Ophthalmic Surgery
|September 1, 1992
PubMed
Summary

Manual corneal epithelium removal before excimer laser photorefractive keratectomy (PRK) impacts ablation depth. Sharp instruments provide more complete epithelial removal than blunt ones, potentially improving PRK outcomes.

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Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Corneal Surface Analysis

Background:

  • Manual corneal epithelium removal is a standard precursor to excimer laser photorefractive keratectomy (PRK).
  • The smoothness of the corneal surface post-deepithelialization can influence laser ablation precision.

Purpose of the Study:

  • To compare the smoothness of the corneal surface after manual deepithelialization using blunt versus sharp instruments.
  • To assess the presence of residual epithelial cells and basement membrane following different manual deepithelialization methods.

Main Methods:

  • Six paired human eye-bank eyes underwent manual deepithelialization: one eye with a blunt Paton spatula, the contralateral with a sharp surgical blade.
  • Corneas were analyzed using scanning electron microscopy (SEM) and light microscopy to evaluate surface smoothness and residual cellular material.

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Main Results:

  • Blunt spatula deepithelialization resulted in residual epithelial cells and basement membrane in 4 out of 6 corneas.
  • Sharp instrument deepithelialization yielded slightly rougher surfaces with occasional scratches in 5 out of 6 corneas, with one retaining minimal basement membrane.
  • Sharp instruments demonstrated more complete epithelium removal compared to blunt instruments.

Conclusions:

  • Sharp instruments appear more effective for complete corneal epithelium removal prior to PRK.
  • Incomplete deepithelialization may affect excimer laser ablation depth, potentially impacting refractive surgery outcomes.