Comparative analysis of corneal histomorphology of adults and children with hyperopia after intrastromal femtosecond laser keratomileusis

Abstract

Purpose. A comparative analysis of cornea histomorphology of adults and children with hyperopic refraction after femtosecond laser intrastromal keratomileusis (FemtoLASIK).Material and methods. Histomorphology in 129 patients (139 eyes) was analyzed using the Confoscan–4 after the operation performed by the FemtoLASIK technique using the devices of the Intralase FS and the MicroScan 2000. The first group included 73 patients (73 eyes) aged 6 to 17 years, the second – 56 patients (66 eyes) aged from 20 to 56 years. The follow-up period was 1 year.Results. Before the operation there were differences between the two groups on the density of keratocytes in the layers of the corneal stroma: in the anterior layer of stroma – by 4.73%, in the middle layer – by 8.18% (p=0.027), in the posterior layer of stroma – by 7.19% higher in children. After the surgery, in both groups the density of keratocytes in the ablation zone dropped, and remained reduced up to 1 year, in children by 41.7%, in adults by 33.53%. In the early postoperative period a more severe degree of epithelial damage was in adults, the inflammatory response to the energy impact dominated in children. In both groups, the scarring formation in the corneal flap started at 1 month, re-innervation – at 3 months, the morphological features of the dry eye syndrome were expressed in a period from 3 to 6 months and decreased at 1 year after surgery.Conclusions. The density of keratocytes in the central stroma was significantly higher in children. After 1 year postoperatively morphological signs of dry eye syndrome decreased in both groups, the density of endothelial cells matched to the age norm, density of keratocytes in the ablation zone remained reduced.

Keywords

• femtosecond laser
• corneal confocal microscopy
• hyperopia
• children