Factors Associated with Incomplete Cleavage of the Corneal Epithelium in Alcohol-Assisted LASEK

Nam Suk Cho; Dong Hee Kim; Kyung Hyun Jin

doi:10.3341/jkos.2011.52.6.665

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Cho, Kim, and Jin: Factors Associated with Incomplete Cleavage of the Corneal Epithelium in Alcohol-Assisted LASEK

Original Article

J Korean Ophthalmol Soc 2011;52(6):665-670.

Published online: 31 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.6.665

Factors Associated with Incomplete Cleavage of the Corneal Epithelium in Alcohol-Assisted LASEK

Nam Suk Cho, MD¹, Dong Hee Kim, MD², Kyung Hyun Jin, MD, PhD¹

¹Department of Ophthalmology, Kyung Hee University School of Medicine, Seoul, Korea

²Department of Ophthalmology, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea

Address reprint requests to Kyung Hyun Jin, MD, PhD, Department of Ophthalmology, Kyung Hee University Medical Center #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: khjinmd@khmc.or.kr

Received 13 August 2010 Revised 12 November 2010 Accepted 22 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the factors associated with unsuccessful cleavage of corneal epithelium in alcohol-assisted LASEK.

Methods

A total of 274 eyes in 137 patients who had received alcohol-assisted LASEK were enrolled in the present study. Associations of central corneal thickness, refractive error, pre-operative corneal curvature, ablation depth, anterior chamber volume and depth, and history of wearing contact lenses with epithelial cleavage were investigated.

Results

Complete epithelial cleavage was achieved in 198 eyes (72.3%) and incomplete epithelial cleavage in 76 eyes (27.7%). A history of wearing contact lenses (p = 0.018), continuous use of contact lenses (p = 0.034), longer use of contact lenses (p = 0.000), anterior chamber volume (p = 0.012) and depth (p = 0.012) were significantly associated with incomplete epithelial cleavage.

Conclusions

Alcohol-assisted LASEK may cause problems in patients who experience continuous use of contact lenses and longer use of contact lenses. Patients with incomplete epithelial cleavage have small anterior chamber volume and shallow anterior chamber depth.

Keywords: Contact lenses, Epithelial cleavage, Epithelial flap, LASEK

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Table 1.

Clinical characteristics of patients

Variables	Data
Number of patients	137
Number of eyes	274
Age (mean ± SD, yr)	26.82 ± 5.87
Male:Female (No. of patients)	45:92
Epithelial flap (No. of eyes)
Complete	198
Incomplete	76
Contact lens (No. of eyes)
User	220
Non-user	54

Table 2.

Contact lens (CL) and flap-related complications

	Incidence (%)		Total	p-value^*
	Complete cleavage	Incomplete cleavage	Total	p-value^*
CL use
User	152 (69.1%)	68 (30.9%)	220
Non-user	46 (85.2%)	8 (14.8%)	54	0.018
Type of CL
Soft lens	126 (67.0%)	62 (33.0%)	188
Hard lens	26 (81.2%)	6 (18.8%)	32	0.147
Duration of CL
≥5 years	61 (56.5%)	47 (43.5%)	108
<5 years	51 (85.0%)	9 (15.0%)	60	0.000
Continuity of use
Intermittent	66 (77.6%)	19 (22.4%)	85
Continuous	81 (63.3%)	47 (36.7%)	128	0.026

^* Chi-square test.

Table 3.

Preoperative patient parameters and flap-related complications

	Complete cleavage (mean ± SD)	Incomplete cleavage (mean ± SD)	p-value^*
Km^† (D)	43.08 ± 3.47	43.64 ± 1.35	0.177
SE^‡ (D)	−5.63 ± 2.44	−5.16 ± 1.94	0.102
Astigmatism (D)	1.47 ± 0.79	1.31 ± 0.67	0.132
CCT^§ (μ m)	542.28 ± 32.50	541.68 ± 31.83	0.892
Ablation (μ m)	73.90 ± 29.76	68.67 ± 24.43	0.140
ACV^∏ (mm³)	204.57 ± 33.37	193.64 ± 27.71	0.012
ACD^＃ (mm)	3.34 ± 0.24	3.25 ± 0.25	0.012

^* Independent t-test

^† Km = mean keratometry

^‡ SE = spherical equivalent

^§ CCT = central corneal thickness

^∏ ACV = anterior chamber volume

^＃ ACD = anterior chamber depth.

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