Photorefractive keratectomy: implications of corneal wound healing.

Tuft, Stephen; Gartry, David; Rawe, Ian; Meek, Keith Michael Andrew

doi:10.1136/bjo.77.4.243

Cited by 88 publications

(54 citation statements)

References 74 publications

(4 reference statements)

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“…Those studies all showed that the cornea heals through a series of well-defined stages and steps 26,27 : active wound healing (initial corneal injury; proliferation and migration of surviving corneal epithelial cells, stromal keratocytes, and endothelial cells; cellular differentiation with active removal, synthesis, and deposition of extracellular material) and tissue remodeling. Corneal function (ie, transparency and wound strength) usually returns to maximal levels, but not always normal levels, after completion of the remodeling stage.…”

Section: Commentmentioning

confidence: 98%

Histologic, Ultrastructural, and Immunofluorescent Evaluation of Human Laser-Assisted In Situ Keratomileusis Corneal Wounds

Dawson¹

2005

Arch Ophthalmol

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To evaluate human corneas after laserassisted in situ keratomileusis at different postoperative intervals.Methods: Thirty-eight postmortem corneas from 20 patients with postoperative intervals from 2 months to 6.5 years after laser-assisted in situ keratomileusis surgery were collected from eye banks. The corneas were trisected and processed for conventional histologic analysis, transmission electron microscopy, and immunofluorescence.Results: Light microscopy and transmission electron microscopy showed focal undulations in Bowman layer, focal epithelial hypertrophic modifications, and a variably thick (range, 0.4-16.4-µm) lamellar stromal interface scar in all specimens. The flap wound margin, which was adjacent to the epithelium, healed by producing an approximately 8-µm-thick hypercellular fibrotic stromal scar,

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Section: Commentmentioning

confidence: 98%

Histologic, Ultrastructural, and Immunofluorescent Evaluation of Human Laser-Assisted In Situ Keratomileusis Corneal Wounds

Dawson¹

2005

Arch Ophthalmol

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“…It is of potential clinical relevance to understand corneal healing dynamics after corrective laser surgery [132,133], and several studies have examined PGs after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Unusually large PG filaments have been observed in lamellar wounds in rabbits 2 weeks after surgery [134], as well as in human corneas several years after LASIK [135,136], but these are believed to be CS/DSPGs.…”

Section: Ks In Stromal Wound Healingmentioning

confidence: 99%

Structural and biochemical aspects of keratan sulphate in the cornea

Quantock

Young

Akama

2009

Cell. Mol. Life Sci.

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Keratan sulphate (KS) is the predominant glycosaminoglycan (GAG) in the cornea of the eye, where it exists in proteoglycan (PG) form. KS-PGs have long been thought to play a pivotal role in the establishment and maintenance of the array of regularly-spaced and uniformly- thin collagen fibrils which make up the corneal stroma. This characteristic arrangement of fibrils allows light to pass through the cornea. Indeed, perturbations to the synthesis of KS-PG core proteins in genetically altered mice lead to structural matrix alterations and corneal opacification. Similarly, mutations in enzymes responsible for the sulphation of KS-GAG chains are causative for the inherited human disease, macular corneal dystrophy, which is manifested clinically by progressive corneal cloudiness starting in young adulthood.

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“…It is believed that excessive corneal wound healing may cause myopic regression and corneal haze after PRK and there is a positive correlation between the amount of haze and myopic regression [8], Histopathologic examin ation o f rabbit corneas after PRK demonstrates an increase in subepithelial fibroblasts and focal areas of subepithelial scarring [9], The clinical observations are very interesting in that sub epithelial wound healing can be effectively eliminated in high myopia by performing the excimer laser ablation with in the stroma (laser in situ keratomileusis, LASIK) [10], This finding indicates that removing the epithelium, or dis turbing Bowman's layer or the anterior corneal stroma stim ulates corneal wound healing dominantly after PRK.…”

Section: Discussionmentioning

confidence: 99%

Aqueous Transforming Growth Factor-Beta-I Levels in Rabbit Eyes after Excimer Laser Photoablation

Bi̇lgi̇han

Güreli̇k²,

Okur³

et al. 1997

Ophthalmologica

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Transforming growth factor β (TGF-β) plays an important role in anterior segment wound healing, by controlling the cell proliferation and differentiation, angiogenesis, extracellular matrix composition and mediating the immunosuppres-sive properties of the aqueous humor. The present study was undertaken to clarify the possible changes of aqueous humor TGF- β₁ levels after excimer laser photoablation. Twenty-eight New Zealand rabbits were divided into four groups of 7 rabbits each. Group 1 served as control, the central 7 mm of corneal epithelium was removed in groups 2, 3 and 4. We performed 50-µm corneal photoablation in group 3, and 100-µm ablation in group 4. After 48 h we measured the TGF- β₁ levels of the aqueous humor by ELISA method. The mean TGF- β₁ value of the aqueous humor was found to be 162.94 ± 13.73 pg/ml in the control group. Mechanical deepithelialization did not change the TGF- β₁ levels of the aqueous humor (p > 0.05). There was no significant difference between the 50-µm photoablated group and the controls (p > 0.05), but the TGF-β₁ levels of the 100-µm photoablated group were found to be significantly higher than those of both the control group and 50-µm photoablated group (p < 0.05). Many factors and cytokines may induce corneal haze and myopic regression after excimer laser photoablation; our study demonstrated that TGF- β₁ is one of these factors and there is a positive correlation between the depth of corneal photoablation and aqueous TGF- β₁ concentrations.

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Photorefractive keratectomy: implications of corneal wound healing.

Cited by 88 publications

References 74 publications

Histologic, Ultrastructural, and Immunofluorescent Evaluation of Human Laser-Assisted In Situ Keratomileusis Corneal Wounds

Histologic, Ultrastructural, and Immunofluorescent Evaluation of Human Laser-Assisted In Situ Keratomileusis Corneal Wounds

Structural and biochemical aspects of keratan sulphate in the cornea

Aqueous Transforming Growth Factor-Beta-I Levels in Rabbit Eyes after Excimer Laser Photoablation

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