Histopathological comparison of photorefractive keratectomy and laser in situ keratomileusis in rabbits

BACKGROUND: After 193 nn excimer laser photorefractive keratectomy (PRK) for myopia, superficial opacities in the ablation zone and regression of refractive results can occur. Clinical studies have emphasized that corneal clarity and early refractive stability can be achieved with laser in situ keratomileusis (LASIK). We present clinical and histological results that compare PRK and LASIK for the treatment of myopia in rabbits. MATERIALS AND METHODS: We treated 12 New Zealand white rabbits with PRK and 12 with LASIK using a 193-nm excimer laser (Aesculap Meditec). In both techniques, the identical excimer software and ablation parameters of -10 D treatment depth were used. Six months after surgery, all eyes were removed and prepared for light, fluorescence and transmission electron microscopy. RESULTS: At the time of enucleation, nine eyes in the PRK group had a moderate to high degree of haze (grade 2 to 3), whereas after LASIK, all corneas showed an almost clear interface in the ablation zone. Correspondingly all histological investigations after LASIK showed a regular stromal architecture, in contrast to the obvious anterior stromal disorganization after PRK. CONCLUSION: The preserved integrity of the superficial corneal layers after LASIK ensures quick wound healing with minimal tissue proliferation, resulting in a transparent corneal interface. This technique appears especially suitable for correcting high myopia.