Corneal endothelial cell changes 5 years after laser in situ keratomileusis: Femtosecond laser versus mechanical microkeratome

Kyle N. Klingler, Jay W. McLaren, William M. Bourne, Sanjay V. Patel

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Purpose: To compare corneal endothelial cell density (ECD) and morphology between flap creation with a femtosecond laser and flap creation with a mechanical microkeratome 5 years after laser in situ keratomileusis (LASIK). Setting: Mayo Clinic, Rochester, Minnesota, USA. Design: Prospective randomized masked paired-eye study. Methods: In this study of LASIK for myopia or myopic astigmatism, fellow eyes were randomized by ocular dominance to flap creation by a femtosecond laser or by a mechanical microkeratome. Central endothelial images were analyzed before and 3 years and 5 years after LASIK; endothelial cell variables were compared between treatments at each examination. Relationships between endothelial cell loss and contact lens wear, residual bed thickness, and preoperative refractive error were evaluated. Results: There were no differences in the ECD, percentage of hexagonal cells, or coefficient of variation of cell area between treatments at any examination (all P =.99); the smallest detectable differences were 120 cells/mm2, 5%, and 2%, respectively. The mean annual rate of corneal endothelial cell loss was -0.1% ± 1.2% (SD) and -0.1% ± 1.0% for the femtosecond laser and the mechanical microkeratome, respectively. Endothelial cell loss was not associated with contact lens wear, residual bed thickness, or preoperative refractive error. Conclusions: The energy delivered to the cornea during femtosecond laser flap creation did not affect the corneal endothelium 5 years after LASIK when compared with flap creation with a mechanical microkeratome. Corneas that have had either method of flap creation could be accepted as donor tissue for endothelial keratoplasty from the standpoint of endothelial health. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Original languageEnglish (US)
Pages (from-to)2125-2130
Number of pages6
JournalJournal of Cataract and Refractive Surgery
Volume38
Issue number12
DOIs
StatePublished - Dec 1 2012

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

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