Ultrastructural comparison of conventional surgical and argon fluoride excimer laser keratectomy

We used scanning electron microscopy to examine the structure of the surfaces created during keratectomy procedures carried out by conventional surgery and ablation by an excimer laser. The walls and the floor of the surgical site were rough with undulations greater than 10 micron in size, caused by broken lamellae and ruptured cells. In contrast, the surfaces produced by the excimer laser were smooth with perturbations of 1 micron or less and were sealed with a pseudomembrane. This smooth, sealed surface produced by the laser is probably responsible for the transparency of the healed cornea in contrast to the scarring produced when a conventional surgical keratotomy heals.