Different epithelial cleavage planes produced by various epikeratomes in epithelial laser in situ keratomileusis

Purpose: To determine the anatomic cleavage planes produced by various epikeratomes in epithelial laser in situ keratomileusis (epi-LASIK). Setting: Department of Ophthalmology, IIsan Paik Hospital, Goyang, Korea. Methods: Sixteen eyes (8 patients) were included in this study. Three epikeratomes, the Moria Epi-K, Centurion SES, and Amadeus II, were used to collect 4 epithelial flaps from 2 patients in the epi-LASIK procedure. Four epithelial flaps from 2 patients were also obtained by laser-assisted subepithelial keratectomy (LASEK). Immunohistochemical staining using monoclonal antibodies against integrin ß1, integrin ß4, laminin 5, and collagen type VII was performed. Results: Immunohistochemical staining showed expression of integrin ß1 and integrin ß4 in all epithelial flaps. In epi-LASIK, the expression of laminin 5 and collagen type VII had a linear or dotted pattern that differed based on the epikeratome used. In the epithelial flaps obtained using LASEK, the expression of laminin 5 and collagen type VII had a dotted pattern. Conclusions: Each epikeratome yielded reproducible but different cleavage planes of corneal epithelium. The results suggest that further study is needed to elucidate the wound-healing process after epi-LASIK because different cleavage planes produced by different epikeratomes may influence the process.