Diamond burring and surgical keratectomy. Morphologic comparison in the rabbit

S. E. Lance, A. Capone Jr, N. SundarRaj, M. I. Roat and R. A. Thoft
Department of Ophthalmology, University of Pittsburgh, PA 15213.

We compared the effects of diamond burring keratectomy (DBK) and surgical superficial lamellar keratectomy (SLK) on the rabbit corneal epithelial healing rate and corneal morphology 1, 4, 7, and 14 days after wounding. Epithelial defects healed significantly more slowly following 10-mm-diameter SLK than following DBK. Restoration of normal epithelial morphology occurred within two weeks in the DBK corneas. During the same interval, SLK corneas showed poor transition of basal to superficial cell morphology. Four days after surgery, the DBK corneas all exhibited marked keratocyte depletion in the anterior stroma but fibrocytes uniformly repopulated this area by 14 days after wounding. Conversely, the SLK corneas all had a hypercellular band of fibrocytes in the anterior stroma by four days following surgery and continued to increase in cellularity through 14 days after wounding. These data indicate that DBK is the preferred procedure for creation of a recipient bed for epithelial lenticles in keratoepithelioplasty and conjunctival transplantation.