Abstract

Clinical results show that photorefractive keratectomy (PRK) offers good predictability, efficacy, and safety. However, its potential risks on the human corneal endothelium are poorly known. We report the results of a prospective study conducted to evaluate the corneal endothelium changes after photorefractive keratectomy. Preoperative and serial postoperative specular microscopy was performed in 14 eyes undergoing excimer laser photorefractive keratectomy. The endothelium was analyzed for a variety of parameters, including cell density, coefficient of variation in cell size, and hexagonality. The follow-up was 6 months. The mean cell density was unchanged from 2463 cells/mm2 to 2498 cells/mm2 at 6 months after photorefractive keratectomy. The coefficient of variation of cell size (polymegathism) changed from 0.303 to 0.280 at 1 month, to 0.293 at 3 months, and to 0.290 at 6 months after surgery. The changes in this parameter were statistically significant when comparing pre- versus 1 month postoperative values. The hexagonality was unchanged from 72.08% at baseline to 73.35% at 6 months. No endothelial abnormalities were found after photorefractive keratectomy. Our results suggest a cell migration from the peripheral to central cornea after photorefractive keratectomy in contact lens wearing patients prior to photorefractive keratectomy.

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