Reassembly of Corneal Epithelial Adhesion Structures After Excimer Laser Keratectomy in Humans
Tamara R. Fountain, MD;
Zenaida de la Cruz;
W. Richard Green, MD;
Walter J. Stark, MD;
Dimitri T. Azar, MD
Arch Ophthalmol. 1994;112(7):967-972.
Abstract
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Objective
To determine the pattern of long-term reformation of the adhesion structures after excimer laser phototherapeutic keratectomy.
Methods
Four corneal buttons were removed at penetrating keratoplasty 6 to 15 months after initial excimer laser phototherapeutic keratectomy. Morphometric analysis of electron micrographs of the wound bed was performed to determine the extent and pattern of reformation of hemidesmosomes, anchoring fibrils, and basal laminae.
Results
Eight percent of the basal epithelial cells had underlying normal anchoring fibrils at 6 months, compared with 35% at 15 months. The percentage of basal cell membrane occupied by hemidesmosomes remained fairly constant (35.2% to 37.7%). With the exception of a localized area of multilamination seen at 9 months, the cross-sectional area of basal lamina per 100 µm of basal cell membrane increased with the duration of wound healing (18.0 µm2 at 6 months, 24.4 µm2 at 15 months) but remained below normal levels (32 µm2).
Conclusions
These data suggest that after human excimer keratectomy, the anchoring fibrils and basal lamina do not completely normalize even after 15 months.
Author Affiliations
From The Wilmer Ophthalmological Institute, The Johns Hopkins Medical Institutions, Baltimore, Md.
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