Article
Wound healing after refractive surgery: in-vitro investigations on human corneas
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Published: | September 22, 2004 |
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Outline
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Objective
Refractive surgery has been used since over 10 years for the correction of ametropia. A lot of studies concerning the wound healing reaction of the cornea have been carried out. Most of them are based on animal trials. However the results of animal trials could not be transferred to humans. Hence aim of this study was to establish an in vitro corneal model.
Methods
Human corneas, which were not suitable for transplantation, have been provided from Bristol eye bank. Following an - 6 dioptres PRK respectively LASEK all corneas have been cultivated in an air interface organ culture. Postoperatively confocal microscopy has been carried out. For morphological evaluation light and electron microscopy has been carried out. Immunoflurescence microscopy has been used to evaluate apoptosis (caspase 3) and proliferation (Ki 67).
Results
After an initial latent phase a continuous wound healing reaction has been observed. Epihtelial closure after PRK has been reached in average after 72 hours. During the first postoperative days an increased apoptosis has been investigated, which reduced during the time. Unlike an prolonged increasement of migration and proliferation of keratocytes has been observed.
Conclusions
With this in vitro model wound healing reactions after refractive surgery could be proofed very well. As these investigations have been carried out on human tissue, they are more likely comparable with the reality. Factors, which are important for wound healing could be defined. Hence at the same attempt medications, which regulate these factors, could be tested.