Alcohol Debridement of the Corneal Epithelium in PRK and LASEK: An Electron Microscopic Study

Abstract

Alcohol delamination of the corneal epithelium before PRK or LASEK consistently results in a very smooth cleavage at the level of the hemidesmosomal attachments, including the superficial lamina lucida. It leaves behind a very smooth surface, which is ideal for PRK. It also allows for an intact epithelial flap to be lifted as a sheet from the corneal surface and hence is ideally suited for the LASEK technique.

Epipolis laser in-situ keratomileusis: an evolving surface ablation procedure for refractive corrections

“…Comparing specimens obtained either with the use of the epikeratome or the classic Camellin's LASEK technique using alcohol, we have shown that the mechanically assisted separation cleavage plane was deeper than that of alcohol. Confirming the findings of other investigators [9][10][11] we have shown that alcohol assisted separations are taking place within the basement membrane whereas the use of the epikeratome can successfully separate the corneal epithelium as a sheet, preserving its basal membrane [12].…”

The Effect of Amniotic Membrane De-Epithelialization Method on its Biological Properties and Ability to Promote Limbal Epithelial Cell Culture

“…29,30 A brief treatment with 20% ethanol resulted in a smooth cleavage at the level of hemi-desmosome attachment at basal lamina, giving viable stromal cells. 31 Urea, a protein denaturant, can solubilize proteins and, hence, cell detachment. 32 It also acts as an osmolyte to cause cell shape changes, and loosen cell-cell and cell-extracellular matrix contacts.…”

Analysis of Ethanol Effects on Corneal Epithelium

“…For instance, application of diluted ethanol (mostly 20% ethanol for 30 seconds) delaminates the corneal epithelium at the level of the hemidesmosomal attachments and creates a smooth stromal surface for further surface ablation by excimer laser. 8 Also, ethanol delamination of the corneal epithelium can be used to obtain specimens for microbial detection in patients with corneal infection. 6 Or ethanol helps to remove abnormal epithelial sheets to allow for firmer adhesion of new epithelial cells in patients with recurrent corneal erosion.…”