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Short-term corneal endothelial changes after photorefractive keratectomy
J J Perez-Santonja1, J Meza, E Moreno
1Department of Ophthalmology, Jimenez-Diaz Foundation, Autonomous University of Madrid School of Medicine, Spain.
Journal of Refractive and Corneal Surgery
|March 1, 1994
Summary
Photorefractive keratectomy (PRK) shows no adverse effects on corneal endothelium cell density or hexagonality over six months. A slight, temporary change in cell size variation was observed, possibly due to peripheral cell migration.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ocular Surface Disease
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery.
- While PRK is known for predictability and efficacy, its impact on the corneal endothelium is not well understood.
- The corneal endothelium plays a vital role in maintaining corneal clarity and function.
Purpose of the Study:
- To prospectively evaluate changes in the human corneal endothelium following photorefractive keratectomy (PRK).
- To assess key endothelial parameters including cell density, polymegathism, and hexagonality post-PRK.
Main Methods:
- Prospective study involving 14 eyes undergoing excimer laser PRK.
- Serial specular microscopy performed preoperatively and up to 6 months postoperatively.
- Analysis of endothelial cell density, coefficient of variation in cell size (polymegathism), and hexagonality.
Main Results:
- Mean endothelial cell density remained stable, with no significant decrease observed (2463 cells/mm² preoperatively to 2498 cells/mm² at 6 months).
- A statistically significant but transient increase in polymegathism was noted at 1 month post-PRK, returning towards baseline by 6 months.
- Corneal endothelial hexagonality showed no significant change from baseline (72.08% to 73.35% at 6 months).
- No endothelial abnormalities were detected throughout the 6-month follow-up period.
Conclusions:
- Photorefractive keratectomy (PRK) appears safe for the corneal endothelium in the short term.
- Observed changes in cell size variation may indicate peripheral to central corneal cell migration, particularly in patients who wore contact lenses pre-PRK.
- PRK does not lead to significant endothelial cell loss or structural changes.