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Session Title: Surface Ablation II
Session Date/Time: Tuesday 08/10/2013 | 16:30-18:00
Paper Time: 17:09
Venue: Main Lecture Hall (Ground Floor)
First Author: : N.Nassiri IRAN
Co Author(s): : N. Nassiri K. Sheibani S. Safi
To compare the effects of alcohol-assisted versus mechanical epithelial debridement on corneal endothelial cells after photorefractive keratectomy using confocal microscopy.
Imam Hossein Medical Center, Tehran, Iran.
This prospective randomized, clinical trial was performed on 88 eyes from 44 patients with the spherical equivalent refraction of <-6.00 diopters. Mechanical versus alcohol-assisted epithelial debridement was done before performing photorefractive keratectomy. One eye of each patient was randomly assigned to one group (mechanical group or alcohol-assisted group) and the fellow eye to the alternate group. Confocal microscopy examination was performed preoperatively and at 3 months postoperatively. The main outcome measures were endothelial cell density, polymegathism and hexagonality as well as the mean endothelial cell area measured three months after the surgery.
In our study no statistically significant difference was noted between study groups in terms of epithelial thickness 3 months postoperatively. Stromal keratocyte density in anterior and middle stroma did not show a difference between two groups but the posterior keratocyte density was higher in alcohol- assisted mechanical debridement. We did not find any statistically significant difference in endothelial cells regarding cell density, mean cell area, hexagonality, and polymegathism.
Based on our findings the adverse effects of mechanical epithelial debridement on corneal endothelial cells is comparable to alcohol-assisted epithelial debridement when MMC is used in both groups. The choice of which method is best is under the discretion of the ophthalmologist.
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