Exposing the LASIK Scam

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 Post subject: Corneal damage after Intralase
PostPosted: Thu Jun 21, 2007 12:38 pm 
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A Comparative Confocal Microscopy Analysis After LASIK With the IntraLase Femtosecond Laser vs Hansatome Microkeratome

Journal of Refractive Surgery Vol. 23 No. 3 March 2007

Manuel Ram?rez, MD; Everardo Hern?ndez-Quintela, MD, MSc; Ram?n Naranjo-Tackman, MD


Quote:
In our study, we observed the same absence of a subepithelial nerve plexus at 1 week and 1 month postoperatively in the eyes operated with the femtosecond laser system. The detection of bright, reflective particles at the interface by confocal microscopy after LASIK has been consistently described in human corneas in previous studies. 6,7 Several theories explain the presence of these reflective particles at the interface. Kaufman et al8 attributed the refl ective particles to surface debris on
the microkeratome blades, probably caused by sterile wax or oil-like material, whereas Hirst and Vandeleur9 attributed them to exposure of the methylcellulose sponges to the excimer laser beam during the stromal
ablation. This issue has yet to be resolved. Dawson et al10 studied these interface refl ective particles after LASIK and made a pathologic correlation, suggesting that the corneal interface wound over the center of the cornea consists of a hypocellular primitive stromal scar, which contains cellular structures that appear on confocal microscopy as interface refl ective particles, such as intracytoplasmic vacuoles at the activated keratocytes, implanted and degenerated epithelial cells, and fragmented fibrillar collagen. In the present study, no significant difference was found in the number of interface refl ective particles
in tissue treated with the femtosecond laser and that treated with the mechanical microkeratome at 1 week and 1 month postoperatively. This finding is consistent with that of Dawson et al,10 and the same types of
refl ective particles were found using both systems. Behind the interface at the ablation zone, the keratocytes appeared as hyper-reflective objects with visible cytoplasm processes, which are the same characteristics
that have been described as activated keratocytes in previous reports.6,7 We found no signifi cant difference in the morphological findings by confocal microscopy at the fl ap interface after LASIK in eyes treated with
the femtosecond laser and a mechanical microkeratome.

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