May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Histopathology and Immunohistology of Corneal Wound Healing in Humans following Laser in situ Keratomileusis (LASIK)
Author Affiliations & Notes
  • I. Schmack
    Ophthalmology, Emory Univ Eye Clinic, Atlanta, Georgia
    Ophthalmology, Ruprecht Karls-University, Heidelberg, Germany
  • W. Gao
    Ophthalmology, Emory Univ Eye Clinic, Atlanta, Georgia
  • D. G. Dawson
    Ophthalmology, Emory Univ Eye Clinic, Atlanta, Georgia
  • H. E. Grossniklaus
    Ophthalmology, Emory Univ Eye Clinic, Atlanta, Georgia
  • H. F. Edelhauser
    Ophthalmology, Emory Univ Eye Clinic, Atlanta, Georgia
  • Footnotes
    Commercial Relationships I. Schmack, None; W. Gao, None; D.G. Dawson, None; H.E. Grossniklaus, None; H.F. Edelhauser, None.
  • Footnotes
    Support NIH Grants EY 000933, P30-EY06360, T3-EY 07092
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 3485. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      I. Schmack, W. Gao, D. G. Dawson, H. E. Grossniklaus, H. F. Edelhauser; Histopathology and Immunohistology of Corneal Wound Healing in Humans following Laser in situ Keratomileusis (LASIK). Invest. Ophthalmol. Vis. Sci. 2007;48(13):3485.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose:: To investigate long term changes in corneal wound healing following laser in situ keratomileusis (LASIK) using routine light and confocal scanning laser microscopy.

Methods:: Thirteen human eye bank corneas from 13 donors (mean±SD: 53.0±9.2 yrs; range 30-70 yrs) with previous LASIK (mean±SD: 4.1±1.9 yrs; range 0.75-7.0 yrs post-op) were studied. Tissue samples were bisected, formalin-fixed and embedded in paraffin according to standard protocols. Six microns thick sections were cut, stained for hematoxylin and eosin (H&E), and periodic acid Schiff (PAS), or were incubated with monoclonal anti-human cellular fibronectin (FN) IgG1 antibody or biotinylated hyaluronic acid binding protein (HABP). Immunoreactivity was detected using FITC conjugated goat anti-mouse IgG (FN) or avidin-horseradish-peroxidase method (HABP). Sections were evaluated for histopathologic and immunohistologic findings at the peripheral (flap margin) and central/paracentral LASIK interface wound by light and confocal scanning laser microscopy.

Results:: LASIK corneas showed 3 histopathologic types of corneal wound healing: epithelial cell modifications (basal cell hypertrophy, hyperplasia), production of a hypercellular fibrotic (flap margin) and a hypocellular primitive stromal scar (central/paracentral interface). LASIK flap thickness measured on average 133.8±15.0µm (range 120 to 160µm). Immunohistochemistry revealed FN in the hypercellular peripheral scar (n=10; flap margin) up to 7 years post-LASIK. A faint signal (FN) was also detected in the central/paracentral interface wound (n=4) in LASIK corneas with thin flaps (≤120µm). Immunostaining for HA was positive at the corneal endothelium and occasionally in subepithelial areas at the flap margin, but negative in the LASIK interface wound and corneal stroma.

Conclusions:: Corneal injury following LASIK results in formation of a hypercellular, fibrotic (flap margin) and a hypocellular, primitive scar(central/paracentral interface). Long-lasting expression of extracellular matrix proteins usually involved in corneal wound healing (i.e. fibronectin) appears to reflect a highly coordinated, bi-directional communication between corneal epithelial cells and stromal keratocytes and may contribute to a more pronounced wound healing response at the LASIK flap margin.

Keywords: wound healing • cytokines/chemokines • refractive surgery: LASIK 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×