0.5% Hypertonic Saline And 20% Alcohol Lasek Corneal Epithelial Comparative Study

Objective: To compare the effectiveness of 5% hypertonic saline versus 20% alcohol to corneal epithelium in histopathology and cytobiology, and evaluate the effectiveness and safety of hypertonic saline (5% sodium chloride) -assisted laser-assisted subepithelial keratectomy (HS-LASEK). Methods: 84 patients(168 eyes) with moderate and low myopia were offered the choices to receive HS-LASEK in one eye and A-LASEK in the other eye (randomly assigned). After 5% hypertonic saline (or 20% achohol) application, a bit of corneal epithelium were scraped up for light microscopes, trypan blue staining and cell culture. Results: From the study of trypan blue staining, the corneal epithelial cells which were infiltrated by 5% hypertonic saline remained satisfactory vitality. The vitality of the corneal epithelial cells between 5% hypertonic saline-exposed and 20% alcohol-exposed had a significant difference. From light microscopic study, the corneal epithelial cells which were infiltrated by 20% alcohol were edema obviously, and some cells were breaded, while in 5% hypertonic saline-exposed corneal epithelium, the basal cells were dehydration. The mean time to epithelial healing was (4.29±0.57) days in A-LASEK eyes, while (3.65±0.28) days in HS-LASEK eyes. 3days after operation, 26.2% (22/84) of A-LASEK eyes and 47.6% (40/84) of HS-LASEK eyes had a visual acuity of 0. 8 or more. One day after operation 22eyes(26.2%) of A-LASEK and 21eyes(25.0%) of HS-LASEK has obvious pains, the difference between the two groups was statistically significant(P<0.05).Conclusion: The cytoactive of corneal epithelium in HS-LASEK was higher than in A-LASEK, In view of recent evidence regarding the epithelial toxic effects of alcohol, HS-LASEK might be a better treatment alternative.