Novel characterization and intravital imaging of lymphangiogenesis and valvulogenesis after lamellar keratoplasty

Abstract

Purpose : Despite the recent emergence of lamellar keratoplasty (LK) as the dominant surgical technique in clinical practice, supplanting full-thickness keratoplasty, we remain in our infancy in our understanding of the mechanisms to lamellar corneal graft rejection. This study was to establish a murine model of LK in Prox-1-GFP mice and to investigate whether graft rejection in this setting is associated with lymphangiogenesis (LG) and valvulogenesis (VG).

Methods : Anterior lamellar keratoplasty was performed between fully mismatched BALB/c (donor) and Prox-1-GFP mice in C57BL/6 background (recipient). Corneal LG and VG were assessed in vivo by a custom built live imaging system. Corneal grafts were evaluated by ophthalmic slit-lamp microscopy and anterior segment optical coherence tomography (OCT).

Results : Over 70% of the lamellar grafts were rejected at 6 weeks post-transplantation. Progressive LG and VG were observed, which were both strongly associated with graft rejection. The thickness of corneal grafts in the rejection group was significantly higher than in the survival group.

Conclusions : This study reveals novel and fundamental mechanisms leading to lamellar graft rejection. Therapeutic strategies targeting LG and VG should offer new approaches to promote graft survival in this setting.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.