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 Citations (Scopus)

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 2012

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Laser In Situ Keratomileusis
Lasers
Endothelial Cells
Refractive Errors
Contact Lenses
Cornea
Corneal Endothelial Cell Loss
Cell Count
ocular Dominance
Corneal Endothelium
Corneal Transplantation
Astigmatism
Myopia
Disclosure
Tissue Donors
Health
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Surgery

Cite this

Corneal endothelial cell changes 5 years after laser in situ keratomileusis : Femtosecond laser versus mechanical microkeratome. / Klingler, Kyle N.; McLaren, Jay W.; Bourne, William M.; Patel, Sanjay V.

In: Journal of Cataract and Refractive Surgery, Vol. 38, No. 12, 12.2012, p. 2125-2130.

Research output: Contribution to journalArticle

Klingler, Kyle N. ; McLaren, Jay W. ; Bourne, William M. ; Patel, Sanjay V. / Corneal endothelial cell changes 5 years after laser in situ keratomileusis : Femtosecond laser versus mechanical microkeratome. In: Journal of Cataract and Refractive Surgery. 2012 ; Vol. 38, No. 12. pp. 2125-2130.
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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.",
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N2 - 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.

AB - 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.

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