Factors Affecting Corneal Strip Stroma-to-Stroma Adhesion

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Abstract
BACKGROUND: Successful laser in situ keratomileusis depends on strong adhesion between the dissected anterior corneal flap and the underlying stromal bed, without suturing. This study attempts to generate new information about the mechanism of this adhesion. METHODS: Strips of fresh bovine corneal stroma were dissected and split apart. The split strips were then made to adhere to each other with varying amounts of combined heat and drying. A relationship was developed between heat applied and hydration of strips. After each heat and drying treatment, the strips were pulled apart and the force needed to accomplish this task was measured. RESULTS: There was a tight linear correlation between increase in temperature and decrease in water content (R p 2 = 0.7414) and between decrease in water content and increase in the adhesive force (R p 2 = 0.3355). CONCLUSION: This model suggests that drying increases stromal-stromal adhesion. We speculate this is due to the increased concentration of surface molecules, which have high ionic charge densities and ionic bonding. A higher concentration of these molecules produces stroma-to-stroma adhesion via ionic bonding. [J Refract Surg 1998;14:460-462]

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