Journal of Refractive Surgery

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Original Articles 

Effectiveness of Cultured Human Keratinocyte Onlays on Epithelial Healing and Clinical Outcome After Photorefractive Keratectomy

Seung Ah Chung, MD; Eung Kweon Kim, MD, PhD; Jin Kook Kim, MD, PhD; IK Hee Ryu, MD; Hyung Keun Lee, MD, PhD

Abstract

PURPOSE

To evaluate epithelial healing time, postoperative pain, corneal haze, and visual and refractive outcomes following the application of cultured sheets of human allogeneic epidermal keratinocyte (CEAK) onlays on the photorefractive keratectomy (PRK) -ablated corneal surface as dressing material.

METHODS

In total, 204 eyes from 103 patients with myopia or myopic astigmatism were prospectively evaluated for 6 months after PRK. The ablated cornea was dressed in three different ways. Specifically, CEAK onlays were placed in 80 eyes (CEAK group), CEAK with amniotic membrane (AM) strips in 63 eyes (CEAK with AM group), and therapeutic contact lenses only in 61 eyes (control group). All eyes were covered with bandage contact lens after the operation. Contact lens removal time, intensity of postoperative pain score on postoperative day 2, corneal haze, Snellen visual acuity, and remaining refractive errors were measured.

RESULTS

The mean contact lens removal time was shorter in the CEAK with AM group (1.84±0.72 days) compared to the control (2.77±1.59 days) and CEAK only (2.24±0.79 days) groups (P<.001). However, no significant differences were evident among the groups in terms of immediate postoperative pain, Snellen visual acuity, remaining refractive errors, and corneal haze at 6 months postoperative.

CONCLUSIONS

The CEAK onlay with AM facilitates epithelial healing, and is thus a good candidate dressing material to decrease the epithelial healing time after PRK. However, this onlay method did not affect the intensity of postoperative pain or final visual outcomes after surgery. [J Refract Surg. 2008;24:826-832.]

ABOUT THE AUTHORS

From the Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine (Chung, E.K. Kim, Ryu, Lee); and Balgeunsesang Ophthalmology Clinic (J.K. Kim), Seoul, Korea.

This study is supported by a faculty research grant of Yonsei University Research Fund of 6-2004-1036.

The authors have no commercial or proprietary interest in the materials presented herein.

Correspondence: Hyung Keun Lee, MD, PhD, Institute of Vision Research, Dept of Ophthalmology, Yonsei University College of Medicine, Yongdong Severance Hospital, 146-92 Dogok-Dong, Kangnam-Ku, Seoul, Korea. Tel: 82 2 3497 3440; Fax: 82 2 3463 1049; E-mail: shadik@yumc.yonsei.ac.kr

Received: January 15, 2007

Accepted: November 7, 2007

Posted online: March 31, 2008

Abstract

PURPOSE

To evaluate epithelial healing time, postoperative pain, corneal haze, and visual and refractive outcomes following the application of cultured sheets of human allogeneic epidermal keratinocyte (CEAK) onlays on the photorefractive keratectomy (PRK) -ablated corneal surface as dressing material.

METHODS

In total, 204 eyes from 103 patients with myopia or myopic astigmatism were prospectively evaluated for 6 months after PRK. The ablated cornea was dressed in three different ways. Specifically, CEAK onlays were placed in 80 eyes (CEAK group), CEAK with amniotic membrane (AM) strips in 63 eyes (CEAK with AM group), and therapeutic contact lenses only in 61 eyes (control group). All eyes were covered with bandage contact lens after the operation. Contact lens removal time, intensity of postoperative pain score on postoperative day 2, corneal haze, Snellen visual acuity, and remaining refractive errors were measured.

RESULTS

The mean contact lens removal time was shorter in the CEAK with AM group (1.84±0.72 days) compared to the control (2.77±1.59 days) and CEAK only (2.24±0.79 days) groups (P<.001). However, no significant differences were evident among the groups in terms of immediate postoperative pain, Snellen visual acuity, remaining refractive errors, and corneal haze at 6 months postoperative.

CONCLUSIONS

The CEAK onlay with AM facilitates epithelial healing, and is thus a good candidate dressing material to decrease the epithelial healing time after PRK. However, this onlay method did not affect the intensity of postoperative pain or final visual outcomes after surgery. [J Refract Surg. 2008;24:826-832.]

ABOUT THE AUTHORS

From the Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine (Chung, E.K. Kim, Ryu, Lee); and Balgeunsesang Ophthalmology Clinic (J.K. Kim), Seoul, Korea.

This study is supported by a faculty research grant of Yonsei University Research Fund of 6-2004-1036.

The authors have no commercial or proprietary interest in the materials presented herein.

Correspondence: Hyung Keun Lee, MD, PhD, Institute of Vision Research, Dept of Ophthalmology, Yonsei University College of Medicine, Yongdong Severance Hospital, 146-92 Dogok-Dong, Kangnam-Ku, Seoul, Korea. Tel: 82 2 3497 3440; Fax: 82 2 3463 1049; E-mail: shadik@yumc.yonsei.ac.kr

Received: January 15, 2007

Accepted: November 7, 2007

Posted online: March 31, 2008

10.3928/1081597X-20081001-10

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