Rotating brush for fast removal of corneal epithelium.

BACKGROUND A simple new device is proposed for safe and very fast epithelial removal of the cornea. This is a rotating plastic brush that removes the corneal epithelium within a few seconds under irrigation, without causing any mechanical damage to the stromal surface. METHODS Comparative SEM and TEM studies on rabbit corneas were carried out following epithelial removal by rotating brush and by a Beaver knife blade. Epithelial removal time and reepithelialization time after photorefractive keratectomy were evaluated in a series of 40 human sighted eyes treated with the brush. RESULTS The rotating brush-abraded surface was smoother compared to the blade-abraded one. Additionally, the brush provoked no damage to the basal lamina of the rabbit corneal epithelium. In human photorefractive keratectomy, the mean time needed for removal of the corneal epithelium by the rotating brush was only 3 sec (range, 2-5 sec). Reepithelialization time following photorefractive keratectomy did not exceed 3 days. CONCLUSION Experimental and preliminary clinical studies suggest that the new rotating plastic brush is a safe and fast method for removing the corneal epithelium.