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Am J Ophthalmol. 2019 May 22. pii: S0002-9394(19)30247-8. doi: 10.1016/j.ajo.2019.05.016. [Epub ahead of print]

Multiple Linear Regression Analysis of the Impact of Corneal Epithelial Thickness on Refractive Error Post Corneal Refractive Surgery.

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Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address:
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Baptist Eye Institute, Kyoto, Japan.
Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.



To evaluate the influence of corneal epithelial thickness (CET) on the deviation from the targeted refraction [refractive error (RE)] post corneal refractive surgery.


Retrospective, single-center, cross-sectional study.


This study involved 211 eyes of 211 patients who previously underwent laser-assisted in situ keratomileusis (LASIK) or epipolis LASIK for the correction of myopia and myopic astigmatism from August 2000 to May 2014 at the Baptist Eye Institute, Kyoto, Japan, and who subsequently underwent examination of CET via optical coherence tomography imaging of 17 zones (central: n=1 zone, paracentral: n=8 zones, and mid-peripheral: n=8 zones) within a 6.0-mm-diameter area of the central cornea from April 2014 to February 2015. The relationship between CET and RE was evaluated using Spearman's coefficient in 5 parameters: CET in the 1) central, 2) paracentral, and 3) mid-peripheral zones, and the difference between the 4) central and paracentral zones and the 5) central and mid-peripheral zones. The influence of CET on RE was evaluated in the CET parameter that showed a significant correlation with RE using multiple liner regression analysis.


The correlation coefficient with RE was 1) -0.238 (P<0.01), 2) -0.172 (P<0.05), 3) -0.002 (P=0.98), 4) -0.186 (P<0.01), and 5) -0.266 (P<0.01), respectively. Multiple liner regression analysis revealed that the difference of mean CET between the central and mid-peripheral zones had a significant influence on RE (β coefficient = -0.028, P<0.01).


The difference between CET at the central and mid-peripheral zones may play a role in the final RE post corneal refractive surgery.


Fourier-domain optical coherence tomography (FD-OCT); corneal epithelial thickness (CET); epipolis-LASIK (epi-LASIK); laser-assisted in situ keratomileusis (LASIK)


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