HEALING OF REOPENED-AND-SUTURED RADIAL KERATOTOMY WOUNDS

We designed a study to evaluate healing in reopened-and-sutured (RAS) keratotomy wounds to determine the efficacy of reoperations in treatin g radial keratotomy overcorrections. Using light and transmission elec tron microscopy, we compared stromal scar tissue organization (transve rse fibroblast orientation and collagen fiber continuity across the wo und) in RAS wounds and in sutured and unsutured control wounds in 18 m onkey eyes one to nine weeks after surgery. Wound healing morphology o f RAS wounds varied with the interval between reoperation and terminat ion of the experiment. Scar tissue organization was sagittal at one we ek postoperatively, transverse in the anterior and mid regions after f our weeks, and transverse over the entire wound after nine weeks. Sutu red wounds showed a similar pattern of healing, although transverse sc ar tissue organization was restricted to the anterior and mid regions in the late healing phases. In contrast, unsutured wounds showed a tem porary, transverse scar tissue organization over the entire wound dept h at two to four weeks and a progressive reorientation of the mid and posterior scar tissue sagittal to the wound at later intervals. The re sults suggest that reopening and saturing keratotomy incisions to trea t radial keratotomy overcorrections may be effective through a myopic shift induced by satured wound apposition and long-term wound remodeli ng, contraction, or both.