Alcohol removal of the epithelium for excimer laser ablation: Outcomes analysis

Stein, Harold; Stein, Raymond; Price, Cindi; Salim, Ghani A.

doi:10.1016/s0886-3350(97)80309-4

Cited by 34 publications

(9 citation statements)

References 2 publications

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“…9 Abad et al 10 found that chemical de-epithelialisation with dilute ethanol (18%) appears to be a safe and effective alternative to mechanical scraping before PRK and might promote faster rehabilitation. The same results were reported by Stein et al 11 who used dilute alcohol (25%) in 91 cases of PRK and found the technique to be effective, predictable, and safe with no significant loss of BCVA, no toxic effects, and no stromal dehydration.…”

Section: Discussionsupporting

confidence: 81%

The epithelial flap for photorefractive keratectomy

Shah

Sarhan²,

Doyle³

et al. 2001

British Journal of Ophthalmology

101

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Background/aims-Epithelial debridement for photorefractive keratectomy (PRK) is associated with pain, slower visual recovery, and may be aetiological in haze production. The aim of this study was to assess the clinical results of a new technique involving raising and replacing of an epithelial flap in photorefractive keratectomy. Methods-A prospective, non-randomised, comparative, paired eye trial was performed in 72 eyes of 36 patients who underwent PRK with a Nidek EC-5000 excimer laser. For epithelial debridement before PRK, the eyes were divided into two groups. The first eye of each patient was treated with 20% ethanol debridement and the second eye with an epithelial flap which was replaced after treatment. PRK was carried out with the same laser and nomogram in both groups by the same surgeon. Visual and refractive outcome of PRK treatment was compared in both groups. a rotating brush, 4 and alcohol debridement. Results-The mean (SD) preoperative mean spherical equivalent (MSE) was 5All of these techniques result in a bare corneal surface which takes 2-3 days to re-epithelialise and another 2 days for the epithelium to settle. Epithelial debridement is not without problems. It is associated with pain which is maximal in the first 24-48 hours and continues until the epithelium heals completely. Visual recovery is delayed until epithelial healing is complete, and the healing process is likely to play a significant role in the production of haze. 6 We hypothesised that a corneal epithelial flap, lifted before laser application,

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Section: Discussionsupporting

confidence: 81%

The epithelial flap for photorefractive keratectomy

Shah

Sarhan²,

Doyle³

et al. 2001

British Journal of Ophthalmology

101

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“…Early reports reveal that epithelial removal using 18% to 25% alcohol for 20 to 25 seconds is fast, easy, and safe to perform compared with mechanical debridement. 59,60 They also show that this concentration can produce sharp wound edges and a clean, smooth Bowman layer and that the central epithelium can be translocated in part or en toto. Carones et al 61 report significantly better haze and corneal regularity results with epithelial debridement using a 20% alcohol solution than with mechanical debridement.…”

Section: Techniques Of Surface Ablation Procedures Photorefractive Kementioning

confidence: 99%

“…8,63 The presence of the basement membrane attached to the basal epithelial cell layer indicates that the point of separation was probably within the basement membrane or between the basement membrane and Bowman layer. 59,64,65 Additionally, the adherence of the basement membrane to the basal layer of the epithelium is significant because the basement membrane is thought to provide the stability and support that keeps the epithelium intact even after manipulation. 65 The preservation of the hemidesmosomes in the basal epithelial layer provides a structure that may promote the adhesion of a viable epithelium to the ablated stroma.…”

Section: Techniques Of Surface Ablation Procedures Photorefractive Kementioning

confidence: 99%

Surface ablation techniques

Taneri

Weisberg

Azar

2011

Journal of Cataract and Refractive Surgery

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The ongoing quest for a safe, simple, effective, minimally invasive, and stable refractive surgical procedure to correct refractive errors has stimulated the development of surface ablation techniques and laser in situ keratomileusis. In this review, we describe the history, patient assessment, techniques, outcomes, and complications of surface ablation (photorefractive keratectomy, laser-assisted sub-epithelial keratectomy, epithelial laser-assisted in situ keratomileusis) and compare the results of various surface techniques. Surface ablation procedures will continue to evolve, with potential improvements in outcomes accompanying future sophisticated ablation profiles and laser technology.

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“…In ophthalmology, it is one of the methods used in the removal of the epithelium during the procedures of refractive surgery, such as photorefractive surgery (PRK) and laser subepithelial keratomileusis (LASEK) (6,7). The molecular mechanism of EtOH-induced apoptosis in corneal fibroblasts remains to be determined.…”

mentioning

confidence: 99%