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W. J. Mayer, A. Wolf, M. Grüterich, C. Lackerbauer, A. Kampik, D. Kook; Comparison of Corneal Inflammation After Flap Creation Using a Mechanical Microkeratome and a 200 Khz Femtosecond Laser - An in vitro Organ Culture Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4862.
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© ARVO (1962-2015); The Authors (2016-present)
To assess corneal inflammatory response within tissue interface after flap creation using a mechanical keratome and a novel 200 kHz femtosecond laser.
Corneoscleral rings of 10 enucleated human eyes not amenable for transplantation were put in organ culture for a period of 14-21 days. Corneal flaps were created using the 200 kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) (group 1) or using a mechanical microkeratome (Amadeus, AMO, Irvine, USA) (group 2). In all corneae that were put into organculture after creation of the flap, flaps were not lifted after laser treatment. In two corneae, no treatment was performed (control group). Thereafter, corneae were kept in organ culture for 6-12 hours at 37°C. In order to evaluate inflammatory reaction, immunofluorescent staining for leukocytes (CD45) and specifically for dendritic cells (HLA-DR) was performed in every group. TUNEL assay was used to objectively determine apoptosis reaction.
Differences were found between keratome and femtosecond laser flap creation in terms of distribution of inflammatory reaction. Apoptosis in proximity to the interface was found in both flap groups. Allocation of both inflammatory reaction and apoptosis was more distinct in vicinity of the side cut. The control group showed neither specific inflammatory reaction nor apoptosis.
These data demonstrate that corneal inflammatory response differs dependent on the type of flap creation either using the novel femtosecond laser technology or the modern mikrokeratome. Our in vitro series of human corneae did not show any marked concerning intensity of inflammatory reaction between the femtolaser and the microkeratome system.
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