Keratocyte density of central human cornea after laser in situ keratomileusis11Proprietary interests: none.

Mitooka, Katsuya; Ramı́rez, Manuel; Maguire, Leo J.; Erie, Jay C.; Patel, Sanjay V.; McLaren, Jay W.; Hodge, David O.; Bourne, William M.

doi:10.1016/s0002-9394(01)01421-0

Cited by 85 publications

(63 citation statements)

References 22 publications

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“…[26][27][28] In other words, corneal opacity arises from the recovery process following corneal defects or PRK, and LASIK also is related to apoptosis. 2,[29][30][31] This conclusion is supported by previous findings indicating that apoptosis is increased in patients with keratoconus and corneal dystrophy, which may influence opacity, thinning, and epulosis in the cornea. 32,33 With respect to apoptosis, the results at 3 weeks after PRK in our present analysis revealed that apoptosis occurs at a level similar to that in the control group.…”

Section: Discussionsupporting

confidence: 85%

Bevacizumab and Rapamycin Can Decrease Corneal Opacity and Apoptotic Keratocyte Number following Photorefractive Keratectomy

Lee

Ko²,

Kim³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We investigated the effects of bevacizumab and rapamycin on central corneal opacity and apoptotic keratocyte number after photorefractive keratectomy (PRK) followed by ultraviolet B (UV-B) irradiation. METHODS.A total of 60 right eyes of Sprague-Dawley rats in four groups (n ¼ 15 each) underwent PRK ablation to 80 lm with a 3-mm zone. Sponges soaked with 0.02% mitomycin C (MMC), 2.5% bevacizumab, 0.01% rapamycin, and balanced saline solution were applied for 2 minutes to these eyes in the MMC, bevacizumab, rapamycin, and control groups, respectively. At 3 weeks after PRK, all right eyes were exposed to 100 mJ/cm 2 UV-B irradiation. Biomicroscopy was used to determine the amount of haze, and TUNEL staining for apoptosis and histology were performed at 3, 6, and 12 weeks.RESULTS. Contrary to the results at 3 weeks, central corneal haze, and apoptotic keratocyte and keratocyte number decreased significantly in the MMC, bevacizumab, and rapamycin groups compared to the control group, and the keratocyte number was lower in the MMC group than the bevacizumab and rapamycin groups at 6 weeks (all P < 0.05). At 12 weeks, the apoptotic keratocyte number was lower in the MMC, bevacizumab, and rapamycin groups than the control group, and the keratocyte number was significantly lower in the MMC than the rapamycin and control groups (all P < 0.05).CONCLUSIONS. Intraoperative bevacizumab and rapamycin administration decreases central corneal haze and apoptotic keratocyte number after PRK. Bevacizumab and rapamycin may be safe alternatives to MMC during refractive surgery to prevent postoperative corneal opacity less affecting the keratocyte number. (Invest Ophthalmol Vis Sci. 2012; 53:7645-7653)

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Section: Discussionsupporting

confidence: 85%

Bevacizumab and Rapamycin Can Decrease Corneal Opacity and Apoptotic Keratocyte Number following Photorefractive Keratectomy

Lee

Ko²,

Kim³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…5 Besides keratoconus and corneal ulcers, the new treatment can be used in corneal melting processes 6 and in the field of refractive surgery to reduce the risk for iatrogenic keratectasia after LASIK (laser assisted in situ keratomileusis). 7 The impact of various treatment modalities like corneal abrasion, PRK (photorefractive keratectomacy), 8 LASIK, 8,9 and epithelial injury [10][11][12] on keratocytes has gained considerable interest in recent years having a possible influence on scarring or corneal thinning. 10 Therefore, as part of a comprehensive safety evaluation, we have undertaken the following experimental study to assess the possible damage to corneal keratocytes after combined riboflavin/UVAtreatment and to compare it to the effect of UVA-irradiation alone.…”

Section: Introductionmentioning

confidence: 99%

“…8,22 Loss of keratocytes has been observed already in other corneal procedures without having dramatic consequences. So after PRK, 8 LASIK, 8,9 or epithelial injury 10-12 keratocyte apoptosis of variable degree was described. However, treatment-related keratocyte apoptosis might be an issue because of the presumptive role of keratocyte apoptosis in the pathogenesis of keratoconus.…”

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confidence: 99%

Keratocyte cytotoxicity of riboflavin/UVA-treatment in vitro

Wollensak

Spoerl

Reber

et al. 2004

Eye

240

183

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Purpose Collagen crosslinking using ultraviolet-A (UVA) -irradiation combined with the photosensitizer riboflavin is a new technique for treating progressive keratoconus. It has been shown to increase effectively the biomechanical strength of the cornea and to stop or even reverse the progression of keratoconus. As part of a safety evaluation, the present study was undertaken to investigate in vitro the possible cytotoxic effect of combined riboflavin/UVA-treatment on corneal keratocytes and to compare it to UVA-irradiation alone. Methods Cell cultures established from porcine keratocytes were treated with 0.025% riboflavin solution and various UVA (370 nm)-irradiances ranging from 0.4 to 1.0 mW/cm 2 and with UVA alone between 2 and 9 mW/cm 2 for 30 min. The cell cultures were evaluated for cell death 24 h after irradiation using trypanblue and Yopro-fluorescence staining. Results An abrupt cytotoxic irradiance level was found at 0.5 mW/cm 2 for keratocytes after UVA-irradiation combined with the photosensitizer riboflavin, which is 10-fold lower than the cytotoxic irradiance of 5 mW/ cm 2 after UVA-irradiation alone. Conclusions A cytotoxic effect of combined riboflavin/UVA-treatment on keratocytes is to be expected at 0.5 mW/cm 2 , which is reached in the clinical setting in human corneas down to a depth of 300 mm using the standard surface UVA-irradiance of 3 mW/cm 2 .

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“…Mitooka et al 22 and Perez-Gomez and Efron 23 observed a 22% and 34% drop in anterior stromal keratocytes 6 and 12 months after myopic laser in-situ keratomileusis (LASIK), respectively. Differences in the severity and duration of these two different forms of mechanical and thermal interventions -epithelial debridement and photoablation versus lens-induced epithelial microtrauma -could account for the differences in the extent of keratocyte loss between contact lens 11,12,14 and refractive surgery studies.…”

Section: Refractive Surgerymentioning

confidence: 99%

Stromal thinning

Efron

2012

Contact Lens Complications

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Keratocyte density of central human cornea after laser in situ keratomileusis11Proprietary interests: none.

Cited by 85 publications

References 22 publications

Bevacizumab and Rapamycin Can Decrease Corneal Opacity and Apoptotic Keratocyte Number following Photorefractive Keratectomy

Bevacizumab and Rapamycin Can Decrease Corneal Opacity and Apoptotic Keratocyte Number following Photorefractive Keratectomy

Keratocyte cytotoxicity of riboflavin/UVA-treatment in vitro

Stromal thinning

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