Faculty Bibliography

We used a disposable bandage soft contact lens piggybacked onto a medicated, 12-hour corneal collagen shield to promote postoperative corneal epithelial healing and to provide sustained delivery of high levels of medications after corneal surgery in patients known to have poor corneal epithelial wound healing characteristics. Our experience with three patients indicates that the collagen shield dissolves completely by the first postoperative day and that the bandage lens remains in place with good mobility until it is removed when epithelialization is complete. This system eliminates the need for painful manipulation and placement of a bandage soft contact lens in an edematous, inflamed eye during the immediate postoperative period

OBJECTIVE: To evaluate histological changes in the primate cornea after excimer laser photorefractive keratectomy (PRK) and to correlate them with clinical observations. METHODS: Sixteen African green monkey (Cercopithecus aethiops sabaeus) corneas were examined by light and transmission electron microscopy 6 weeks to 18 months after 1.5- or 3-diopter PRK. RESULTS: All specimens had a smooth stromal surface surrounded by a smooth, centrally tapered Bowman's layer. Epithelial thickness appeared to peak 12 months after PRK. The trend was for the epithelium to be thickest in the central-treated area; this phenomenon was more obvious in the 3-diopter-treated corneas. The numbers of activated keratocytes beneath the treated zone peaked at 4 months and decreased thereafter, while the numbers in the untreated areas decreased in the first 2 months after surgery, increased by 4 months, and did not change thereafter. Regenerated basal lamina averaged 86% intact over ablated areas; thickness was normal and no duplications were seen. Overall, the density of hemidesmosomes was significantly less in ablated areas compared with unablated areas. CONCLUSIONS: These findings support the relationship between clinical observations of corneal haze after PRK, reestablishment of the epithelial cell layer, and the potential for stromal remodeling by active fibroblastic keratocytes beneath the ablation zone. Overall, quantification of several morphological parameters indicated that the values for the treated zone tended, with time, to approach those of the untreated cornea after PRK