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Assessment of conjunctival epithelium after laser in situ keratomileusis by impression cytology

1 May 2001


Purpose: To assess the effect of laser in situ keratomileusis (LASIK) on the conjunctival epithelium and its possible relationship to dry eye complications following the LASIK procedure.

Methods: Impression cytology samples of 15 patients were analyzed pre and post operatively. Impression samples were collected from the temporal bulbar conjunctiva utilizing Millipore cellulose acetate filter paper. These specimens were fixed with 95% ethanol, stained with periodic acid Schiff technique, analyzed by light microscopy and graded based on representative photomicrographs.

Results: At two weeks post LASIK, 13 patients (86.7%) demonstrated a reduction in goblet cell density and epithelial cell hypertrophy, while 2 patients remained unchanged (p

Conclusion: The appositional force against the bulbar conjunctival epithelium generated by the microkeratome suction ring during laser in situ keratomileusis causes a significant decrease in the conjunctival goblet cell density and significantly affects epithelial cell morphology in otherwise healthy eyes. These changes in the ocular surface may be implicated in the dry eye complications commonly found after LASIK.


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