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Lee, Lee, and Kyung: Corneal Endothelial Cell Changes after LASEK and M-LASEK
Original Article

J Korean Ophthalmol Soc 2013;54(10):1501-1507.

Published online: 3 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.10.1501

Corneal Endothelial Cell Changes after LASEK and M-LASEK

Seung Jae Lee, MD1, Damho Lee, MD, PhD2, Haksu Kyung, MD, PhD1

1Department of Ophthalmology, National Medical Center, Seoul, Korea

2Vision Eye Center, Seoul, Korea

Address reprint requests to Damho Lee, MD, PhD Vision Eye Center, #581-15 Sinsa-dong, Gangnam-gu, Seoul 135-120, Korea, Tel: 82-2-548-3579, Fax: 82-2-540-1431, E-mail: damholee@naver.com

Received 18 March 2013       Revised 15 May 2013       Accepted 5 August 2013

Copyright © 2013 Korean Ophthalmological Society

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

In this study we evaluated the changes in the corneal endothelial cells before and after the operation among myopes in the M-LASEK group, on whom 0.02% mitomycin C (MMC) was used and in the LASEK group, on whom MMC was not used.

Methods

The corneal endothelial cell analysis was performed in 104 eyes of 57 subjects in the LASEK group and in 86 eyes of 48 subjects in the M-LASEK group before the operation, and 3 months and 12 months postoperatively.

Results

There were no statistically significant differences in the corneal endothelial cell density (CD), the cell area coefficient of variance (CV), and hexagonal cell rate (6A) between the 2 groups before the operation, and 3 months and 12 months postoperatively (p> 0.05). In the LASEK group, there were no statistically significant differences (p> 0.05) in CD when the numerical values before the operation and 3 months and 12 months after the operation were compared, but there were statistically significant differences in CV and 6A when comparing before the operation and 12 months postoperatively (p= 0.001, p = 0.034, respectively). In the M- LASEK group, there was a 2.8% statistically significant decrease (p= 0.004) in CD when the numerical values before the operation and 3 months after the operation were compared, but there were no statistically significant difference (p> 0.05) when the numerical values before the operation and 12 months after the operation were compared. In addition, there were no statistically significant differences (p> 0.05) in CV and 6A when the numerical values before the operation and 3 months and 12 months after the operation were compared.

Conclusions

M-LASEK, contrary to LASEK, showed statistically significant differences in CD in short-term results such as 3 months postoperatively, but in long-term observation such as 12 months postoperatively, both groups showed no statistically significant differences.

Keywords: Corneal endothelial cells, LASEK, M-LASEK, Mitomycin C

References

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Figure 1.
Corneal endothelial changes after LASEK and M-LASEK. Paired t-test *p = 0.004; †p = 0.001; ‡p = 0.034. CD = endothelial cell density; CV = coefficient of variation of cell area; 6A = hexagonality.
jkos-54-1501f1.tif
Table 1.
Preoperative demographics of patients in LASEK group and M-LASEK group
LASEK M*-LASEK p-value†
Age (years) 28.6 ± 7.8 (19∼50) 26.9 ± 6.9 (18∼43) 0.260
Male : Female (eyes) 19 : 85 21 : 65 0.654
Preoperative SE (D) −4.04 ± 1.20 (-1.38∼-6.38) −7.09 ± 1.15 (-5.0∼-9.5) <0.001
Corneal thickness (μm) 543 ± 35 (464∼651) 541 ± 31 (482∼604) 0.727
Ablation thickness (μm) 87 ± 16 (40∼112) 129 ± 12 (104∼151) <0.001
Total (eyes) 104 86

SE = spherical equivalent; D = diopter.

* Mitomycin C;

† From the unpaired t-test (p < 0.05 significant).

Table 2.
Preoperative and postoperative data for the cell density (CD), the coefficient of variation (CV), the hexagonality (6A) in two groups
CD (cells/mm2) CV 6A (%)
Preop
 LASEK (n = 104) 3237 ± 322 33.8 ± 5.6 57.5 ± 9.7
 M-LASEK (n = 86) 3328 ± 304 33.1 ± 7.8 59.7 ± 11.6
 p-value* 0.081 0.405 0.187
Postop 3 months
 LASEK (n = 48) 3147 ± 353 32.6 ± 5.4 59.4 ± 5.4
 M-LASEK (n = 60) 3236 ± 315 31.4 ± 5.1 58.8 ± 10.7
 p-value* 0.172 0.232 0.745
Postop 12 months
 LASEK (n = 104) 3238 ± 320 31.3 ± 5.2 60.0 ± 10.0
 M-LASEK (n = 86) 3274 ± 292 31.4 ± 5.3 59.5 ± 10.9
 p-value* 0.432 0.891 0.729

Values are presented as mean ± SD.

* From the unpaired t-test (p < 0.05 significant).

Table 3.
Changes in corneal endothelium indices after LASEK
Time CD (cells/mm2) p-value* CV p-value* 6A (%) p-value*
Preop (n = 104) 3237 ± 322 − 33.8 ± 5.6 − 57.5 ± 9.7 −
Postop
 3 months (n = 48) 3147 ± 353 0.083 32.6 ± 5.4 0.122 59.4 ± 5.4 0.203
 12 months (n = 104) 3238 ± 320 0.628 31.3 ± 5.2 0.001 60.0 ± 10.0 0.034

Values are presented as mean ± SD.

* From the paired t-test, preoperative versus postoperative value (p < 0.05 significant).

Table 4.
Changes in corneal endothelium indices after M-LASEK
Time CD (cells/mm2) p-value* CV p-value* 6A (%) p-value*
Preop (n = 86) 3328 ± 304 − 33.1 ± 7.8 − 59.7 ± 11.6 −
Postop
 3 months (n = 60) 3236 ± 315 0.004 31.4 ± 5.1 0.147 58.8 ± 10.7 0.682
 12 months (n = 86) 3274 ± 292 0.055 31.4 ± 5.3 0.057 59.5 ± 10.9 0.905

Values are presented as mean ± SD.

* From the paired t-test, preoperative versus postoperative value (p < 0.05 significant).

Table 5.
Prevalence of corneal opacity and uncorrected visual acuity (UCVA) on 12 months after LASEK and M-LASEK
LASEK M-LASEK p-value
Corneal opacity 8/104 5/86 0.26*
UCVA† (decimal visual acuity)
 Preop 0.10 ± 0.10 0.04 ± 0.05
 Postop 12 months 1.00 ± 0.03 0.95 ± 0.13

Values are presented as mean ± SD.

* From Chi-square test;

† From Hahn's vision test chart for 3M.

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