Light and electron microscopic evaluation of canine corneal endothelium following CO2 photokeratotomy.

Abstract

OBJECTIVE: To determine using light and scanning electron microscopy if treatment with CO2 photokeratotomy alters the corneal endothelium in healthy dogs. PROCEDURE: Eight surgery laboratory dogs were determined to be free of ocular abnormalities. Under general anesthesia, the left eye of each dog was treated in a quadrant from 12 to 3 o'clock with the CO(2) laser in a defocused mode. The right eye served as a control. There were four treatment groups, each with 2 dogs: group 1 (2 W, 0.1 J/s, 0.8 mm tip), group 2 (3 W, 0.3 J/s, 0.8 mm tip), group 3 (2 W, 0.04 J/s NovaScan), group 4 (3 W, 0.06 J/s, NovaScan). The 0.8 mm tip delivered a power density of 382 W/cm(2) or 573 W/cm(2), at 2 or 3 watts respectively. The NovaScan handpiece delivered a power density of 30 W/cm(2) or 40 W/cm(2), at 2 or 3 Watts respectively. Following euthanasia, right and left corneas including a 2-mm scleral rim were harvested and fixed in commercial grade Karnovsky's fixative. One piece of cornea was processed routinely, embedded in Embed 812 resin, sectioned at 1 um, stained with toluidine blue and evaluated with the light microscope. A separate piece of each cornea was routinely processed and examined with a JEOL 6400 scanning electron microscope (SEM) at 20 KV. RESULTS: No changes in endothelial cell morphology were detected by light microscopy in the sections examined. SEM indicated normal endothelial cell morphology in control eyes with presumed artifactual changes at the corneal free margin (4/8 eyes). Multiple punctate to linear regions of endothelial cell destruction were observed in 6/8 laser-treated corneas. A significant increase in corneal thickness ranging from 1.90 to 37.28% was observed in all laser treated corneas. This increase in thickness correlated linearly with the degree of endothelial damage. Ultrastructural findings also correlated with postoperative clinical findings. CONCLUSION: CO2 laser photokeratotomy alters corneal endothelial cell morphology and thickness.