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Jeffrey W. Ruberti, Stephen D. Klyce, Michael K. Smolek, Michael D. Karon; Anomalous Acute Inflammatory Response in Rabbit Corneal Stroma. Invest. Ophthalmol. Vis. Sci. 2000;41(9):2523-2530.
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purpose. To investigate the nature and cause of an acute, anomalous stromal
edema after epithelial débridement in the rabbit cornea.
methods. Series I: Adult New Zealand White rabbit corneas were mounted in
perfusion chambers. The endothelium was bathed with Ringer’s fluid,
and the outer surface was covered with silicone oil. The epithelium of
one eye was débrided with a scalpel before mounting, and the
cornea of the fellow eye was débrided with a rotating brush after
stabilization in the perfusion chamber. Using specular microscope
tracking software, it was possible to measure total swelling and local
swelling within the cornea. Series II: Diclofenac sodium ophthalmic
solution 0.1% or a placebo was applied topically, 1 drop per 45
minutes for 3 hours before animals were euthanatized.
results. Series I: Corneas with their epithelium scraped with a scalpel before
mounting were 37.5 ± 17.5 μm (n = 6; P < 0.001) thicker in vitro than the stromas of
perfused, intact fellow corneas. Epithelial débridement with a
rotating brush after mounting resulted in an immediate (within 8
minutes) stromal swelling that plateaued in 1 hour at 31.0 ± 5.3μ
m (n = 6; P < 0.001). Curiously, in six
of six corneas, the anterior stroma swelled more than the posterior
stroma. In four of six corneas, the posterior stroma thinned. Analysis
showed this pattern to be consistent with a sudden increase in anterior
swelling pressure or osmotic pressure and to be inconsistent with a
change in endothelial transport properties. Series II: Placebo-treated
corneas swelled 30.6 ± 7.7 μm (n = 5) 1 hour after
débridement, whereas corneas pretreated with diclofenac sodium
swelled only 19.2 ± 3.1 μm (n = 6; P < 0.008).
conclusions. The anterior stromal swelling occurs rapidly and near the site of
epithelial injury suggesting messenger and/or enzymatic involvement
with an effect parallel to apoptosis. Reduction of the swelling
response with nonsteroidal anti-inflammatory drugs (NSAIDs) implicates
the cyclooxygenase pathway. The swelling is similar to the unexplained
acute edema that occurs during inflammation in the rat paw edema model,
and may represent a general mechanism for mobilization of inflammatory
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