Morphologic changes of corneal epithelial flap: ethanol-mediated versus mechanical removal.

PURPOSE: To evaluate morphologic changes in human corneal epithelial flap removed mechanically or after ethanol application.

METHOD: Epithelial corneal flap was removed after ethanol application (20 eyes) or mechanically (19 eyes). Any changes were studied by transmission electron microscopy.

RESULTS

Thirty-nine eyes were enrolled in the study. The following changes were found in the alcohol-applied group: apoptotic cells, membrane-bound blebs with marked dilatation of endoplasmic reticulum, and short intercellular cleavage with approximately one-third of cell length depth. In mechanical debridement, cleavages extended more than half of the cell length by tearing hemidesmosomes.

CONCLUSION

Alcohol application leads to cell damage in basal epithelial cells but cleavage plane remains smooth. Generally, none of the methods caused trauma to the basement membrane.