Effect of amniotic membrane after laser-assisted subepithelial keratectomy on epithelial healing : Clinical and refractive outcomes

Abstract

PURPOSE: To evaluate the effect of an amniotic membrane (AM) on reepithelialization time, corneal haze, and postoperative visual and refractive outcomes after laser-assisted subepithelial keratectomy (LASEK) for myopia and myopic astigmatism. SETTING: Department of Ophthalmology, Yonsei University College of Medicine, and Balgeunsesang Ophthalmology Clinic, Seoul, Korea. METHODS: One hundred fifty-two eyes of 84 patients with myopia or myopic astigmatism were prospectively evaluated for 6 months after LASEK. An AM was placed as a strip on the inferior limbus in 94 eyes of 54 patients after LASEK; 58 eyes of 30 patients served as the control group. Postoperative epithelial healing time, uncorrected visual acuity (UCVA), best corrected visual acuity, remaining refractive error, and corneal haze were examined. RESULTS: The reepithelialization time was shorter in the AM group (2.40 days +/- 0.94 [SD]) than in the control group (3.90 +/- 0.97 days) (P<.001). At 6 months, 86 eyes (91.5%) in the AM group had a UCVA of 20/25 or better and 90 eyes (95.7%) had a UCVA of 20/40 or better; 48 eyes (82.8%) and 53 eyes (91.4%) in the control group had a UCVA of 20/25 or better and 20/40 or better, respectively. The mean spherical equivalent in the AM group was -0.48 +/- 0.54 diopter (D) and in the control group, -0.94 +/- 0.60 D (P<.001). The corneal haze was significantly less in the AM group than in the control group (P<.001). CONCLUSION: Amniotic membrane use after LASEK induced rapid epithelial healing with more favorable visual and refractive outcomes and lower corneal haze scores than conventional LASEK.