Confocal Microscopic Findings Associated with LASIK Flap with Foreign Corneal Epithelial Cells

Purpose: To evaluate the inflammatory response following the insertion of corneal epithelium into rabbit corneal stroma using confocal microscope. Methods : Newzealand white rabbits were underwent corneal flap procedure using Microkeratome (Hansatome, Chiron, USA) and corneal epithelium was inserted. We divided the rabbits into three groups: Group A: flap only, Group B: flap with central epithelium insertion, Group C: flap with peripheral epithelium insertion. We examined the rabbit corneas at the time point of 4, 24, 72hours, 7days, and 1 month after surgery using confocal microscope and CD 11b immunohistochemical stain. Results: At the early stage, the inflammatory cells were more frequently observed in the group C than in the group A and B, and at postoperative 72hours only in the group C. In stromal and total corneal thickness, there was a tendency of increase to the postoperative 24 hours and decrease in all groups, but the group C was more stronger tendency than other groups (P0.05). In immunohistochemical staining (CD11b), polynucleated cells and mast cells were more visible in group Band C than in group A. Conclusions : The postoperative inflammatory reaction of the LASIK flap may be related with corneal epithelial cells, and we think that more attention should be needed with the management of microkeratome.