Corneal wound healing after photoablation with a 213nm scanning solid-state laser. Histological and ultrastructural study

Purpose: To investigate wound healing in rabbits after corneal photoablation with a 213 nm UV scanning solid state laser. Materials and Methods: We used a frequency quintupled Nd:YAG laser to photoablate the cornea of 32 rabbits (5 mm ablation zone, 6 D myopic correction). The contralateral eyes and the eyes of 3 untreated animals served as controls. Light and electron microscopy analyses were performed on postoperative days 0, 7, 28, 90. Results: Abnormal, light basal epithelial cells were observed during the first postoperative month, but normal epithelial maturation was evident at 3 months. Basement membrane duplication was noted. Keratocyte proliferation occurred in the anterior stroma and in a few cases, in the posterior stroma, where keratocyte activation was present. Degenerative endothelial changes were observed immediately after ablation with intracellular disorganization and junction alteration. Surface profiles with variable regularity led to variable wound healing. Conclusions: Apart from differences in epithelial basal cell appearance, photoablation with a 213 nm solid state laser induced wound healing processes similar to those observed previously with prototype ArF excimer lasers. It is hoped that laser refinements will improve the surface regularity and lead to more consistent wound healing responses. However, several studies are required to assess mutagenicity, penetration depth and ablation rate of the 213nm wavelength on ocular tissues, as well as the effects of hydration on the clinical outcome.