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Endothelial Cell Loss Following Radial Keratotomy in a Primate Model

Endothelial Cell Loss Following Radial Keratotomy in a Primate Model Abstract • The effect of radial keratotomy on the corneal endothelium of subhuman primates was studied by serial specular microscopy and histopathology. Fixedframe analysis of specular micrographs of 13 operated eyes at one month after surgery revealed an endothelial cell loss of 13% (±4%). Follow-up of all 13 eyes for six months disclosed no statistically significant progressive endothelial cell loss. Similarly, no significant loss could be demonstrated in five eyes followed up for 18 months and two eyes followed up four years after surgery. Variable frame analyses of specular micrographs of all 13 unoperated eyes followed up for six months also did not suggest progressive endothelial cell loss following radial keratotomy. Histopathology and ultrastructural studies of corneas undergoing radial keratotomy disclosed no abnormalities suggesting ongoing endothelial cell damage. These findings suggest that radial keratotomy produces an acute postoperative endothelial cell loss that is nonprogressive. Much longer term follow-up with larger numbers of subjects is necessary before the ultimate delayed effects of radial keratotomy on the endothelium can be determined. References 1. Fyodorov SN, Durnev VV: Operation of dosaged dissection of corneal circular ligament in cases of myopia of mild degree . Ann Ophthalmol 1979;11:1885-1890. 2. Bores LD, Myers W, Cowden J: Radial keratotomy: An analysis of the American experience . Ann Ophthalmol 1981;13:941-948. 3. Cowden JW, Bores LD: A clinical investigation of the surgical correction of myopia by the method of Fyodorov . Ophthalmology 1981;88:737-741.Crossref 4. Fyodorov SN, Agranovsky AA: Long-term results of anterior radial keratotomy . Ocular Ther Surg 1982;1:217-223. 5. Hecht SD, Jamara RS: Prospective evaluation of radial keratotomy using the Fyodorov formula: Preliminary report . Ophthalmology 1982;14:319-330. 6. Kremer FB, Marks RG: Radial keratotomy: Prospective evaluation of safety and efficacy . Ophthalmic Surg 1983;14:925-930. 7. Nirankari VS, Katzen LW, Karesh LE, et al: Ongoing prospective clinical study of radial keratotomy . Ophthalmology 1983;90:637-641.Crossref 8. Rowsey JJ, Balyeat HD: Preliminary results and complications of radial keratotomy . Am J Ophthalmol 1982;93:437-455. 9. Hoffer KJ, Darin JJ, Pettit TH, et al: Three years experience with radial keratotomy: The UCLA study . Ophthalmology 1983;90:627-636.Crossref 10. Sarno EM, Smith RE, Schanzlin DJ: Visual results and complications of radial keratotomy, extended wear contact lenses and myopic keratomileusis . Int Ophthalmol Clin 1982;22:167-177. 11. Jester JV, Steel D, Salz J, et al: Radial keratotomy in non-human primate eyes . Am J Ophthalmol 1981;92:153-171. 12. Yamaguchi T, Kanai A, Tanaka M, et al: Bullous keratopathy after anterior posterior radial keratotomy for myopia and myopic astigmatism . Am J Ophthalmol 1982;93:600-606. 13. Salz JJ: Progressive endothelial cell loss following repeat radial keratotomy: A case report . Ophthalmic Surg 1983;13:997-999. 14. Binder PS, Stainer GA, Zavala EY, et al: Acute morphologic features of radial keratotomy . Arch Ophthalmol 1983;101:1113-1116.Crossref 15. Steel D, Jester JV, Salz J, et al: Modification of corneal curvature following radial keratotomy in primates . Ophthalmology 1981;88:747-754.Crossref 16. Yamaguchi T, Polack FM, Valenti J, et al: Endothelial damage after anterior radial keratotomy: An electron microscopic study of rabbit cornea . Arch Ophthalmol 1981;99:2151-2158.Crossref 17. Yamaguchi T, Kaufman HE, Fukushima A, et al: Histologic and electron microscopic assessment of endothelial damage produced by anterior radial keratotomy in the monkey cornea . Am J Ophthalmol 1981;92:313-327. 18. Laing RA, Sandstrom MM, Berrospi AR, et al: Changes in the corneal endothelium as a function of age . Exp Eye Res 1976;22:587-594.Crossref 19. Doughman DJ, Van Horn D, Rodman WP, et al: Human corneal endothelial layer repair during organ culture . Arch Ophthalmol 1976; 94:1791-1796.Crossref 20. Rao GN, Shaw EL, Arthur E, et al: Morphological appearance of the healing corneal endothelium . Arch Ophthalmol 1978;96:2027-2030.Crossref 21. Binder PS, Akers P, Zavala EY: Endothelial cell density determined by specular microscopy and scanning electron microscopy . Ophthalmology 1979;86:1831-1847.Crossref 22. Funabashi M, Yoshida M, Kanai A, et al: A case of bullous keratopathy after anterior-posterior incision of the cornea for myopia . Folia Ophthalmol Jpn 1973;24:19-28. 23. Gelender H, Flynn HW Jr, Mandelbaum SH: Bacterial endophthalmitis resulting from radial keratotomy . Am J Ophthalmol 1983;93:323-326. 24. Baldone JA, Franklin RM: Cataract following radial keratotomy . Ann Ophthalmol 1983; 15:416-418. 25. Stainer GA, Shaw EL, Binder PS, et al: Histopathology of a case of radial keratotomy . Arch Ophthalmol 1982;100:1473-1477.Crossref 26. Fyodorov SN, Sarkizova MB, Kurasova TP: Corneal biomicroscopy following repeated radial keratotomy . Ann Ophthalmol 1983;15:403-407. 27. Santos CRI: Herpetic corneal ulcer following radial keratotomy . Ann Ophthalmol 1983; 15:82-85. 28. Jester JV, Villasenor RA, Miyashiro J: Epithelial inclusion cysts following radial keratotomy . Arch Ophthalmol 1983;101:611-615.Crossref 29. Luttrull JK, Jester JV, Smith RE: The effect of radial keratotomy on ocular integrity in an animal model . Arch Ophthalmol 1982;100:319-320.Crossref 30. Katz HR, Duffin RSM, Glasser DB, et al: Complications of contact lens wear after radial keratotomy in an animal model . Am J Ophthalmol 1982;94:377-382. 31. Cowden JW, Cichocki J: Radial keratotomy in monkeys: A one-year follow-up report . Ophthalmology 1982;89:684-686.Crossref 32. Treffers WF: Human corneal endothelial wound repair: In vitro and in vivo . Ophthalmology 1982;89:605-613.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Endothelial Cell Loss Following Radial Keratotomy in a Primate Model

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1984.01040031350025
Publisher site
See Article on Publisher Site

Abstract

Abstract • The effect of radial keratotomy on the corneal endothelium of subhuman primates was studied by serial specular microscopy and histopathology. Fixedframe analysis of specular micrographs of 13 operated eyes at one month after surgery revealed an endothelial cell loss of 13% (±4%). Follow-up of all 13 eyes for six months disclosed no statistically significant progressive endothelial cell loss. Similarly, no significant loss could be demonstrated in five eyes followed up for 18 months and two eyes followed up four years after surgery. Variable frame analyses of specular micrographs of all 13 unoperated eyes followed up for six months also did not suggest progressive endothelial cell loss following radial keratotomy. Histopathology and ultrastructural studies of corneas undergoing radial keratotomy disclosed no abnormalities suggesting ongoing endothelial cell damage. These findings suggest that radial keratotomy produces an acute postoperative endothelial cell loss that is nonprogressive. Much longer term follow-up with larger numbers of subjects is necessary before the ultimate delayed effects of radial keratotomy on the endothelium can be determined. References 1. Fyodorov SN, Durnev VV: Operation of dosaged dissection of corneal circular ligament in cases of myopia of mild degree . Ann Ophthalmol 1979;11:1885-1890. 2. Bores LD, Myers W, Cowden J: Radial keratotomy: An analysis of the American experience . Ann Ophthalmol 1981;13:941-948. 3. Cowden JW, Bores LD: A clinical investigation of the surgical correction of myopia by the method of Fyodorov . Ophthalmology 1981;88:737-741.Crossref 4. Fyodorov SN, Agranovsky AA: Long-term results of anterior radial keratotomy . Ocular Ther Surg 1982;1:217-223. 5. Hecht SD, Jamara RS: Prospective evaluation of radial keratotomy using the Fyodorov formula: Preliminary report . Ophthalmology 1982;14:319-330. 6. Kremer FB, Marks RG: Radial keratotomy: Prospective evaluation of safety and efficacy . Ophthalmic Surg 1983;14:925-930. 7. Nirankari VS, Katzen LW, Karesh LE, et al: Ongoing prospective clinical study of radial keratotomy . Ophthalmology 1983;90:637-641.Crossref 8. Rowsey JJ, Balyeat HD: Preliminary results and complications of radial keratotomy . Am J Ophthalmol 1982;93:437-455. 9. Hoffer KJ, Darin JJ, Pettit TH, et al: Three years experience with radial keratotomy: The UCLA study . Ophthalmology 1983;90:627-636.Crossref 10. Sarno EM, Smith RE, Schanzlin DJ: Visual results and complications of radial keratotomy, extended wear contact lenses and myopic keratomileusis . Int Ophthalmol Clin 1982;22:167-177. 11. Jester JV, Steel D, Salz J, et al: Radial keratotomy in non-human primate eyes . Am J Ophthalmol 1981;92:153-171. 12. Yamaguchi T, Kanai A, Tanaka M, et al: Bullous keratopathy after anterior posterior radial keratotomy for myopia and myopic astigmatism . Am J Ophthalmol 1982;93:600-606. 13. Salz JJ: Progressive endothelial cell loss following repeat radial keratotomy: A case report . Ophthalmic Surg 1983;13:997-999. 14. Binder PS, Stainer GA, Zavala EY, et al: Acute morphologic features of radial keratotomy . Arch Ophthalmol 1983;101:1113-1116.Crossref 15. Steel D, Jester JV, Salz J, et al: Modification of corneal curvature following radial keratotomy in primates . Ophthalmology 1981;88:747-754.Crossref 16. Yamaguchi T, Polack FM, Valenti J, et al: Endothelial damage after anterior radial keratotomy: An electron microscopic study of rabbit cornea . Arch Ophthalmol 1981;99:2151-2158.Crossref 17. Yamaguchi T, Kaufman HE, Fukushima A, et al: Histologic and electron microscopic assessment of endothelial damage produced by anterior radial keratotomy in the monkey cornea . Am J Ophthalmol 1981;92:313-327. 18. Laing RA, Sandstrom MM, Berrospi AR, et al: Changes in the corneal endothelium as a function of age . Exp Eye Res 1976;22:587-594.Crossref 19. Doughman DJ, Van Horn D, Rodman WP, et al: Human corneal endothelial layer repair during organ culture . Arch Ophthalmol 1976; 94:1791-1796.Crossref 20. Rao GN, Shaw EL, Arthur E, et al: Morphological appearance of the healing corneal endothelium . Arch Ophthalmol 1978;96:2027-2030.Crossref 21. Binder PS, Akers P, Zavala EY: Endothelial cell density determined by specular microscopy and scanning electron microscopy . Ophthalmology 1979;86:1831-1847.Crossref 22. Funabashi M, Yoshida M, Kanai A, et al: A case of bullous keratopathy after anterior-posterior incision of the cornea for myopia . Folia Ophthalmol Jpn 1973;24:19-28. 23. Gelender H, Flynn HW Jr, Mandelbaum SH: Bacterial endophthalmitis resulting from radial keratotomy . Am J Ophthalmol 1983;93:323-326. 24. Baldone JA, Franklin RM: Cataract following radial keratotomy . Ann Ophthalmol 1983; 15:416-418. 25. Stainer GA, Shaw EL, Binder PS, et al: Histopathology of a case of radial keratotomy . Arch Ophthalmol 1982;100:1473-1477.Crossref 26. Fyodorov SN, Sarkizova MB, Kurasova TP: Corneal biomicroscopy following repeated radial keratotomy . Ann Ophthalmol 1983;15:403-407. 27. Santos CRI: Herpetic corneal ulcer following radial keratotomy . Ann Ophthalmol 1983; 15:82-85. 28. Jester JV, Villasenor RA, Miyashiro J: Epithelial inclusion cysts following radial keratotomy . Arch Ophthalmol 1983;101:611-615.Crossref 29. Luttrull JK, Jester JV, Smith RE: The effect of radial keratotomy on ocular integrity in an animal model . Arch Ophthalmol 1982;100:319-320.Crossref 30. Katz HR, Duffin RSM, Glasser DB, et al: Complications of contact lens wear after radial keratotomy in an animal model . Am J Ophthalmol 1982;94:377-382. 31. Cowden JW, Cichocki J: Radial keratotomy in monkeys: A one-year follow-up report . Ophthalmology 1982;89:684-686.Crossref 32. Treffers WF: Human corneal endothelial wound repair: In vitro and in vivo . Ophthalmology 1982;89:605-613.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Nov 1, 1984

References