April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Modulating Wound Healing after Collagen Cross-linking
Author Affiliations & Notes
  • Marina Hovakimyan
    Department of Ophthalmology, University of Rostock, Rostock, Germany
    Institute of Biomedical Engineering, University of Rostock, Rostock, Germany
  • Rudolf F Guthoff
    Department of Ophthalmology, University of Rostock, Rostock, Germany
  • Klaus P Schmitz
    Institute of Biomedical Engineering, University of Rostock, Rostock, Germany
  • Oliver Stachs
    Department of Ophthalmology, University of Rostock, Rostock, Germany
  • Footnotes
    Commercial Relationships Marina Hovakimyan, None; Rudolf Guthoff, None; Klaus Schmitz, None; Oliver Stachs, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4701. doi:
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      Marina Hovakimyan, Rudolf F Guthoff, Klaus P Schmitz, Oliver Stachs; Modulating Wound Healing after Collagen Cross-linking. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4701.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: Corneal Cross-Linking (CXL) is an established minimally-invasive procedure for the treatment of corneal thinning in keratoconus and post-LASIK-ectasia. However, a complete keratocyte loss after CXL and an associated risk for corneal opacification and melting still remains an unwanted treatment effect. In the present study we examine, whether a regenerating matrix therapy agent (RGTA, Cacicol®) which has already been shown to be effective in the treatment of chronic corneal ulcers, could positively influence the cell regeneration.

Methods: New Zealand White albino rabbits were divided in three groups, in which the corneae underwent CXL according to the standard protocol. While in the control group (1) no further medication was performed, the two additional groups were instilled with two drops of CACICOL20 before (2) or after (3) CXL. Epithelial healing was examined by fluorescein-staining and keratocyte regeneration was evaluated using in vivo confocal laser-scanning microscopy (Heidelberg Retina Tomograph/Rostock Cornea Module) for up to one week. The epithelial morphology and keratocytes distribution was examined histologically using DAPI and Hemalaun/Eosin staining.

Results: Three days after CXL all corneae were significantly swollen and demonstrated a complete cell loss throughout the entire thickness. Morphologically, no differences were seen between CACICOL-treated (2, 3) and untreated (1) groups at that time point. One week post-treatment, the anterior and middle stroma was completely devoid of cells in the control group (1) and only typical dendritic like optical elements, corresponding to the cell remnants were visualized. In contrast, the CACICOL-treated animals (2, 3) revealed hyperreflective repair keratocytes in the middle and also in the anterior stroma. Migrating spindle-shaped activated keratocytes were observed in the posterior stroma.

Conclusions: In our previous studies we have demonstrated that the keratocyte density remains significantly reduced for up to 20 weeks after CXL. Here, we have the first evidence that the keratocyte repopulation can be accelerated by applying a new ophthalmologic solution based RGTA technology. It should be mentioned, however, that these results are preliminary, and need to be quantitatively confirmed further in a larger group of animals.

Keywords: 484 cornea: stroma and keratocytes • 765 wound healing  

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