Human excimer laser lamellar keratectomy. A clinical study

Ophthalmology. 1989 May;96(5):654-64. doi: 10.1016/s0161-6420(89)32836-3.


The first ten blind human eyes in the United States to receive excimer laser (ArFl 193 nm) lamellar keratectomy (reprofiling) are presented. Seven of these patients were followed 6 to 12 months after ablation. All eyes are grossly clear in the region of ablation. Results of slit-lamp examination of all flattened ablated areas show mild superficial haze at the epithelial/stromal interface. This haze might not interfere significantly with vision in patients 7 to 10. Serial pachymetry and keratometry measurements, refraction, and digital keratoscopy show a progressive filling in of the excavated area by approximately two thirds but a loss of initial diopteric correction of only one third. Histopathologic analysis was obtained for four eyes. Transmission electron microscopy of three eyes enucleated 3 to 12 days after ablation shows 40-microns ablation depths through Bowman's layer and superficial stroma with minimal adjacent tissue damage and no inflammatory cells. The epithelium is increased in thickness by 50%, and firmly attached to the underlying stroma. A 4-month postablation specimen shows keratocyte activation with increased protein synthesis (presumed collagen and ground substance).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blindness / etiology
  • Cornea / surgery*
  • Corneal Diseases / pathology
  • Corneal Diseases / surgery*
  • Epithelial Cells
  • Eye Neoplasms / complications
  • Follow-Up Studies
  • Glaucoma / complications
  • Humans
  • Laser Therapy*
  • Melanoma / complications
  • Time Factors
  • Ultraviolet Rays