Role of the endothelial pump in flap adhesion after laser in situ keratomileusis

Purpose: To investigate the role of the endothelial pump in the attachment of the corneal flap during the early period after laser in situ keratomileusis (LASIK). Setting: Department of Ophthalmology, Tokyo Dental College, Tokyo, Japan. Methods: The study comprised 30 porcine eyes. In all eyes, a corneal flap was made with a microkeratome. Five minutes after the flap was placed over the bed, the adhesion strength was measured with a load-testing machine. To inhibit the endothelial pump, ouabain was injected into the anterior chamber (10 eyes) or the endothelium was mechanically scraped (10 eyes). The control group included 10 eyes. Results: The load needed to lift the flap was significantly lower in the ouabain group (0.21 gram force [gf]; P<.01) and the endothelial scrape group (0.22 gf; P<.01) than in the control group (0.61 gf). Conclusion: The endothelial pump plays an important role in flap attachment in the early postoperative period after LASIK (C) 2004 ASCRS and ESCRS.