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Christian Meltendorf, Guido J. Burbach, Christian Ohrloff, Estifanos Ghebremedhin, Thomas Deller; Intrastromal Keratotomy with Femtosecond Laser Avoids Profibrotic TGF-β1 Induction. Invest. Ophthalmol. Vis. Sci. 2009;50(8):3688-3695. doi: 10.1167/iovs.08-2699.
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purpose. To examine expression of the profibrotic cytokine TGF-β1 after selective intrastromal corneal injury with the use of a femtosecond laser.
methods. Rabbits underwent monocular intrastromal keratotomy at a preoperatively determined corneal depth of 160 to 200 μm with the use of a femtosecond laser. Femtosecond laser-induced TGF-β1 expression was compared in nonoperated control eyes and eyes treated with photorefractive keratectomy (PRK). Follow-up examinations were performed 1, 3, 7, and 28 days after surgery. TGF-β1 protein was identified by immunofluorescence labeling. With the use of laser-capture microdissection, epithelial, stromal, and endothelial cell layers were collected, and changes in TGF-β1 mRNA expression were quantified with quantitative RT-PCR.
results. TGF-β1 mRNA and protein expression did not significantly increase after intrastromal femtosecond laser keratotomy. In contrast, TGF-β1 was induced in corneal epithelial and stromal cells after PRK and showed up to 23-fold higher TGF-β1 mRNA levels compared with control corneas. The increase of TGF-β1 mRNA levels after PRK was accompanied by increased TGF-β1 protein production.
conclusions. Isolated stromal injury with a femtosecond laser does not result in induction of the profibrotic cytokine TGF-β1. Because TGF-β1 has been implicated in a fibrotic response of the corneal stroma to injury, absence of TGF-β1 induction argues for a favorable wound-healing response. These findings support highly selective intrastromal procedures in refractive surgery.
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