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Adrienne Csutak, József Tözsér, László Békési, Ziad Hassan, András Berta, David M. Silver; Plasminogen Activator Activity in Tears after Excimer Laser Photorefractive Keratectomy. Invest. Ophthalmol. Vis. Sci. 2000;41(12):3743-3747.
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purpose. To quantify changes of plasminogen activator activity in tear fluid
during corneal re-epithelialization after excimer laser photorefractive
methods. Tear samples were collected with glass capillaries from 77 eyes of 42
patients immediately before and immediately after PRK treatment and on
postoperative days 3 and 5. In 20 patients, the contralateral eye was
similarly sampled to serve as control. Plasminogen activator activity
in the tear samples was measured by a spectrophotometric method using
human plasminogen and chromogenic peptide substrate, d-valyl-l-leucyl-l-lysine-p-nitroanilide
results. In tears of all eyes that underwent PRK, the plasminogen activator
activities were lower immediately after PRK than were the preoperative
values. For patient eyes with normal wound healing, tear plasminogen
activator activities were significantly elevated above the preoperative
level on the third postoperative day and then returned to the
preoperative level by the fifth postoperative day. In contrast, tear
plasminogen activator activities remained low through the third
postoperative day in all (six) eyes in which haze developed after 3 to
6 months. The contralateral control eyes showed no appreciable change
in plasminogen activator activity over the 5-day period.
conclusions. Plasminogen activator activity levels measured in tears of excimer
laser PRK-treated eyes may serve as a predictor of wound healing.
Extended low levels of plasminogen activator activity through the third
postoperative day correlate with the development of corneal healing
abnormalities (haze). The low plasminogen activator activity could be
not only an accompanying sign but also a cause of defective corneal
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