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Nicole J. Anderson, MD; Henry F. Edelhauser, PhD; Nariman Sharara, MD; Keith P. Thompson, MD; Roy S. Rubinfeld, MD; Dawn M. Devaney, OD; Nancy L'Hernault, MA; Hans E. Grossniklaus, MD

Arch Ophthalmol. 2002;120:288-293.

Objective  To examine the histologic and ultrastructural features of human corneas after successful laser in situ keratomileusis (LASIK) in 2 patients post mortem.

Methods  Portions of 4 corneas were processed for histology, transmission electron microscopy, and scanning electron microscopy.

Results  Case 1 had undergone LASIK 3 months prior to death and case 2 had undergone LASIK 20 months prior to death. A Hansatome (Bausch & Lomb Surgical Inc, Clarement, Calif) microkeratome with a 180-µm plate had been used for case 1 and an Automated Corneal Shaper (Chiron Corporation, Munich, Germany) with a 160-µm plate had been used for case 2. Histologically, the LASIK flap measured 160 µm and 150 µm in thickness in case 1 and case 2, respectively. Corneas from both cases exhibited minor epithelial ingrowth into the wound, reactive keratocytes at the wound margin, irregular collagen fibrils in the wound bed, and severed collagen bundles at the flap hinge. These findings were more pronounced in case 1 than in case 2, and the wound interface was virtually imperceptible in case 2. Additionally, the corneas from case 1 contained periodic acid-Schiff–positive electron dense material and wide-spaced collagen at the wound interface, and there was an absence of corneal nerves.

Conclusions  These findings show that changes caused by wound repair that are present at 3 months are minor 20 months after LASIK.

From the Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga (Drs Anderson, Edelhauser, Sharara, Thompson, and Grossniklaus, and Ms L'Hernault); and Washington Eye Physicians and Surgeons, Chevy Chase, Md (Drs Rubinfeld and Devaney). The authors have no propriety interest in any of the products mentioned.

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