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KMID : 0350519930460010285
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Journal of Catholic Medical College
1993 Volume.46 No. 1 p.285 ~ p.297
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Histologic Comparison of Conventional Surgical and Excimer Laser Superficial Karatectomy in Rabbit Eyes
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Abstract
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Excimer laser ultraviolet radiation therapy(argon fluoride, 193nm) has been used to ablate the cornea with minimal damage to residual underlying stroma, Therefore laser photorefractive keratectomy can be perlormed to correct myopia.
However, for this technique to be successful, corneal wound healing must occur without stromal scarring and epithelial hyperplasia. Therefore we studied the healing process following excimer laser keratectomy and then compared with that of the conventional surgical keratectomy using slit-iamp, light microscope, and electron microscope in rabbit eyes. The excimer laser keratectomy was done with a depth of 61μm, and the conventional surgical keratectomy was made with about 1/5 of corneal
thickness. The repair process was followed up for 6 months after surgery.
In both keratectomy wounds, keratectomy surface was more reepithelized by 3 to 4 days and epithelial hyperplasia was more prominant in surgically keratectomized wound. Scanning electrom incroscopy showed that the afblated surface after laser Skeratectomy
was distinctively smooth and obscured the underlying cellular and extracellular elements, whereas the floors of the surgically keratectomized beds showed iffegularity resulting from exposed, damaged keratocytes and contused, frayed lamellae.
Transmission electrom microscopy showed the undulation of basement membrane and active keratocytes in superficial stroma of both laser and surgically keratectomized cases until postoperative one month and these changes were more frequent after
surgical keratectomy.
There were no remarkable changes at the posterior stroma and endothelium during the follow-upperiod. From these results, the excimer laser keratectomy is a more precise, less traumatic surgery to ablate superficial layer of the cornea selectively than
the conventional surgical keratectomy and can induce a normal woud healing without damage of surrounding tissues.
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