The detection of corneas operated on for refractive surgery [LASIK or photorefractive keratectomy (PRK)] will become a major concern for eye banks in the coming years because this surgery is often forgotten during the interview with the deceased's relatives. We present here 2 corneas operated on with PKR and stored successively in organ culture (OC) and in the active storage machine (ASM) that restores intraocular pressure, restores the cornea to its original shape, respects transparency and incorporates non-invasive controls. The 2 corneas of a 49-year-old donor operated 17 years earlier by PRK for -2 and -3 diopters myopia were stored in OC for 14 days and then placed in ASM for 48 h. Thickness map and OCT topography were performed under the 2 storage conditions, histology and electron microscopy were then performed. Traces of PRK remained unnoticed in OC while they were evident in ASM with central epithelial anomaly, central thinning and flattening of central keratometry shown by OCT. Histology and ultrastructure confirmed the absence of Bowman's membrane in the center. By placing the cornea under physiological conditions, and in particular by triggering its deswelling and by restoring its natural curvature, the ASM allows effective detection of subtle refractive surgery traces like those present after PRK.

在未来几年，屈光手术 [LASIK 或光性屈光性角膜切除术 (PRK)] 的角膜检测将成为眼库的主要关注点，因为在与死者亲属的面谈中经常忘记这种手术。我们在此展示了 2 种使用 PKR 进行手术的角膜，并连续储存在器官培养 (OC) 和活性储存机 (ASM) 中，可恢复眼压、将角膜恢复到其原始形状、尊重透明度并结合非侵入性控制。一名 49 岁捐献者的 2 个角膜在 17 年前由 PRK 手术治疗 -2 和 -3 屈光度近视，在 OC 中保存 14 天，然后在 ASM 中放置 48 小时。在两种储存条件下进行厚度图和 OCT 形貌，然后进行组织学和电子显微镜检查。PRK 的痕迹在 OC 中仍未被注意到，而在 ASM 中则很明显，OCT 显示中央上皮异常、中央变薄和中央角膜曲率变平。组织学和超微结构证实中心没有鲍曼膜。通过将角膜置于生理条件下，特别是通过触发其消肿和恢复其自然曲率，ASM 可以有效检测细微的屈光手术痕迹，如 PRK 后存在的痕迹。