Closure of the Corneal Incision After Intraestromal Ring Segment Implantation Reduce Stromal Wound Healing

Abstract

Purpose: : To evaluate the effect of intracorneal segments (ICRS) implantation in the corneal wound healing process.

Methods: : PMMA (polimetil methacrilate) segments (Ferrara) were implanted in the right eye of 44 lohmann classic hens. In the left fellow control eyes, only a channel was created.The time of epithelial closure was measured with fluorescein. Stromal incision, channel evolution, haze and complications were evaluated under surgical microscope and slip lamp. At different time points, corneas were removed and fixed for histopathology analysis.

Results: : There were not differences between right and left corneas in the time of the epithelial incision closure (8±4 hours).A persistent stromal incision (fish mouth form), was observed in the implanted corneas (10±5 days) while this incision disappeared in the first days (3±2) in the non-implanted corneas (p<0,05).An increase in the grade of haze around the channel was only observed in the right eyes (2,00± 0,5 one month after surgery) while left eyes remains transparent (p<0,05).Differences in the number of death cells between groups, were not observed in the first hours after surgery. Cell proliferation and differentiation, TGFβ-1 liberation and TGFβ-RII expression were observed around the channel, only in implanted corneas.

Conclusions: : Corneal incision should be sealed after ICRS implantation in order to reduce stromal fibrosis.

Keywords: cornea: stroma and keratocytes • keratoconus • wound healing