Corneal endothelial changes after laser-assisted in situ keratomileusis combined with high-fluence cross-linking

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Abstract

Purpose
To evaluate corneal endothelial cells before and after laser-assisted in situ keratomileusis (LASIK) combined with accelerated, high-fluence collagen cross-linking (CXL) in myopic patients.
Patients and methods
In a prospective comparative nonrandomized interventional case series study, 60 myopic eyes of 30 patients (seven males and 23 females) with age ranged from 18 to 35 years were distributed into two groups. Group A included 30 eyes of 15 patients, treated by LASIK, whereas group B included 30 eyes of 15 patients treated by LASIK associated with high-fluence CXL. All patients were subjected to preoperative and 3- and 6-month postoperative evaluation of corneal endothelial profile using specular microscope.
Results
Qualitative and quantitative analysis of the corneal endothelial cells comparing the two groups showed statistically significant changes in endothelial cell density (=0.040) at 3-month follow-up after the procedure, which improved to reach a value close to preoperative values, with no significant changes between the two groups at 6-month follow-up (=0.081). There was no significant change in polymegathism or coefficient of variation and in the percentage of hexagonal cells (pleomorphism) in each group and in comparing between the two groups at 3- and 6-month follow-up.
Conclusions
LASIK with high-fluence CXL is safe and has no adverse effect on corneal endothelium.

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