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Damage to epithelial basement membrane by thermokeratoplasty
American Journal of Ophthalmology
|March 1, 1977
Summary
Thermokeratoplasty (TKP) can damage the corneal basement membrane, causing persistent defects. Faulty epithelial adhesion is expected after TKP and requires aggressive treatment, potentially with contact lenses.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Electron Microscopy
Background:
- Thermokeratoplasty (TKP) is a surgical procedure used to reshape the cornea.
- The corneal epithelium's basement membrane is crucial for tissue integrity and adhesion.
- Understanding TKP's impact on the basement membrane is vital for patient outcomes.
Purpose of the Study:
- To investigate the effects of thermokeratoplasty (TKP) on the corneal epithelial basement membrane complexes.
- To assess both acute and long-term changes following TKP.
Main Methods:
- Transmission electron microscopy was utilized.
- Corneal buttons from patients with failed TKP and from acute TKP cases (normal and keratoconus corneas) were examined.
Main Results:
- Acute TKP consistently caused thermal dissolution of the basement membrane.
- Persistent basement membrane defects were observed many months after therapeutic TKP.
Conclusions:
- Thermokeratoplasty can significantly damage the corneal epithelial basement membrane.
- Clinicians should anticipate and aggressively manage faulty epithelial adhesion post-TKP.
- Prophylactic use of hydrophilic contact lenses may be beneficial.