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Laura Schollhorn, Franziska Bucher, Felix Bock, Claus Cursiefen, CorneaLab; Corneal Photodynamic Ablation of Lymphatic Vessels improves Corneal Graft Survival. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5048.
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Corneal (lymph)angiogenesis is a prime risk-factors for immune rejection after transplantation. We recently presented a technique to regress pre-existing pathological corneal lymphatic vessels prior to transplantation by photodynamic therapy (PDT). Here we analysed the effect of photodynamic regression of corneal lymphatic vessels on subsequent corneal graft survival.
The murine model of high-risk keratoplasty was used by placing three interrupted 11-0 sutures into the corneal stroma of BALB/c mice and leaving them in place for 2 weeks. Thereafter, the treatment group received an intrastromal injection of verteporfin (controls: PBS) followed by PDT. Subsequently, one, two or three weeks later penetrating keratoplasty was performed with C57BL/6 donors (all mice female). Postoperative survival of the grafts was analyzed over 8 weeks subsequently.
Performing PK in high risk eyes two or three weeks after corneal stromal PDT resulted in significantly higher graft survival rates (p<0.005 and p<0.05, respectively; n=8). When performing the corneal transplantation one week after corneal stromal PDT, no significant difference in graft survival could be detected (p>0.05; n=7).
This study for the first time shows that PDT after corneal intrastromal verteporfin injection is a new “preconditioning strategy” to reduce pre-existing corneal lymphatic vessels prior to transplantation and thereby to prevent allograft rejection in the high-risk situation.
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