Slitlamp, specular, and light microscopic findings of human donor corneas after laser-assisted in situ keratomileusis.

Objective To examine slitlamp, specular, and light microscopic features of humandonor corneas known to have undergone laser-assisted in situ keratomileusis(LASIK). Methods Twenty-six donor corneas known to have undergone LASIK prospectivelyunderwent slitlamp examination with particular attention to the presence ofa flap edge, as well as specular microscopy with particular attention to thepresence of highly reflective particles in the stroma corresponding to theLASIK interface. Central endothelial cell density and pachymetery were obtained.They were compared with 26 control donor corneas without LASIK. Eleven LASIKdonor corneas were processed for histology. Twenty-six donor corneas withno known prior keratorefractive surgery also underwent similar slitlamp examinationand specular microscopy to serve as controls. Results Twelve (46%) of 26 LASIK donor corneas had an obvious flap edge, and10 (39%) had a subtle flap edge by slitlamp examination. Four (15%) had infiltratesby slitlamp examination, of which 3 were confirmed by histopathologic examination.Highly reflective particles were seen by specular microscopy in the stromaof 23 (88%) of 26 LASIK donor corneas, but only 1 (4%) of 26 control donorcorneas had a single highly reflective particle in the stroma ( P 2 in the LASIK group compared with 2250 cells/mm 2 in the controls ( P = .39). Vacuolizationand pyknosis of keratocytes was a consistent histopathologic finding afterLASIK. Metallic particles at the interface were not detected by histology. Conclusions Detection of a flap edge by slitlamp examination may detect at leasthalf of the donor corneas that may have undergone LASIK. The detection ofhighly reflective stromal particles may form an effective basis for screeningfor LASIK donor corneas using specular microscopy and requires further study.