Reduction in corneal haze and apoptosis by amniotic membrane matrix in excimer laser photoablation in rabbits

Ming X. Wang, Trevor B. Gray, Woo Chan Park, Pinnita Prabhasawat, William W Culbertson, Richard Forster, Khalil Hanna, Scheffer C G Tseng

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Abstract

Purpose: To determine whether preserved human amniotic membrane can reduce corneal haze and keratocyte apoptosis induced by excimer laser photoablation in rabbit corneas. Methods: Excimer photoablation was performed bilaterally in 30 rabbits with a 6.0 mm ablation zone and 120 μm depth using the VlSX Star laser with the phototherapeutic keratectomy (PTK) mode. One eye was randomly covered by preserved human amniotic membrane secured with 4 interrupted 10-0 nylon sutures, and the other eye served as the control. The amniotic membranes were removed at 1 week, and corneal haze was graded with slitlamp biomicroscopy by 3 masked corneal specialists biweekly for the ensuing 12 weeks until the rabbits were killed. Another 18 rabbits were divided into 4 subgroups and received PTK alone, PTK with membrane, PTK with sham sutures, or PTK with tarsorrhaphy. All eyes were studied histologically, and 3 eyes in each group were studied by in situ terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling assay at 1, 3, and 7 days and 12 weeks, respectively. Results: A consistent grading of differences in corneal haze scoring between the control corneas and the amniotic-membrane-covered corneas was noted among the 3 masked observers. Organized reticular post-PTK corneal haze peaked at 7 weeks in both groups, and the corneal haze score in the amniotic-membrane-covered group was significantly less than in the control group from 7 to 12 weeks (all P < .001). Compared to the control corneas, the amniotic-membrane-covered corneas had less inflammatory response at 1 and 3 days, less keratocyte apoptosis in the ablated anterior corneal stroma at 1, 3, and 7 days (P < .001), and less stromal fibroblast cellularity and epithelial hyperplasia at 12 weeks. Conclusions: Amniotic membrane matrix introduced at an early stage of the corneal wound healing process effectively reduced corneal haze induced by excimer laser photoablation in rabbits. Studies linking suppression of apoptosis in the acute wound-healing process with reduction of subsequent corneal scarring may have useful clinical applications.

Original languageEnglish
Pages (from-to)310-319
Number of pages10
JournalJournal of Cataract and Refractive Surgery
Volume27
Issue number2
DOIs
StatePublished - Mar 10 2001

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Excimer Lasers
Amnion
Apoptosis
Rabbits
Cornea
Wound Healing
Sutures
Corneal Keratocytes
Corneal Stroma
DNA Nucleotidylexotransferase
Nylons
Hyperplasia
Cicatrix
Lasers
Fibroblasts
Control Groups
Membranes

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Reduction in corneal haze and apoptosis by amniotic membrane matrix in excimer laser photoablation in rabbits. / Wang, Ming X.; Gray, Trevor B.; Park, Woo Chan; Prabhasawat, Pinnita; Culbertson, William W; Forster, Richard; Hanna, Khalil; Tseng, Scheffer C G.

In: Journal of Cataract and Refractive Surgery, Vol. 27, No. 2, 10.03.2001, p. 310-319.

Research output: Contribution to journalArticle

Wang, Ming X. ; Gray, Trevor B. ; Park, Woo Chan ; Prabhasawat, Pinnita ; Culbertson, William W ; Forster, Richard ; Hanna, Khalil ; Tseng, Scheffer C G. / Reduction in corneal haze and apoptosis by amniotic membrane matrix in excimer laser photoablation in rabbits. In: Journal of Cataract and Refractive Surgery. 2001 ; Vol. 27, No. 2. pp. 310-319.
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abstract = "Purpose: To determine whether preserved human amniotic membrane can reduce corneal haze and keratocyte apoptosis induced by excimer laser photoablation in rabbit corneas. Methods: Excimer photoablation was performed bilaterally in 30 rabbits with a 6.0 mm ablation zone and 120 μm depth using the VlSX Star laser with the phototherapeutic keratectomy (PTK) mode. One eye was randomly covered by preserved human amniotic membrane secured with 4 interrupted 10-0 nylon sutures, and the other eye served as the control. The amniotic membranes were removed at 1 week, and corneal haze was graded with slitlamp biomicroscopy by 3 masked corneal specialists biweekly for the ensuing 12 weeks until the rabbits were killed. Another 18 rabbits were divided into 4 subgroups and received PTK alone, PTK with membrane, PTK with sham sutures, or PTK with tarsorrhaphy. All eyes were studied histologically, and 3 eyes in each group were studied by in situ terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling assay at 1, 3, and 7 days and 12 weeks, respectively. Results: A consistent grading of differences in corneal haze scoring between the control corneas and the amniotic-membrane-covered corneas was noted among the 3 masked observers. Organized reticular post-PTK corneal haze peaked at 7 weeks in both groups, and the corneal haze score in the amniotic-membrane-covered group was significantly less than in the control group from 7 to 12 weeks (all P < .001). Compared to the control corneas, the amniotic-membrane-covered corneas had less inflammatory response at 1 and 3 days, less keratocyte apoptosis in the ablated anterior corneal stroma at 1, 3, and 7 days (P < .001), and less stromal fibroblast cellularity and epithelial hyperplasia at 12 weeks. Conclusions: Amniotic membrane matrix introduced at an early stage of the corneal wound healing process effectively reduced corneal haze induced by excimer laser photoablation in rabbits. Studies linking suppression of apoptosis in the acute wound-healing process with reduction of subsequent corneal scarring may have useful clinical applications.",
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AU - Wang, Ming X.

AU - Gray, Trevor B.

AU - Park, Woo Chan

AU - Prabhasawat, Pinnita

AU - Culbertson, William W

AU - Forster, Richard

AU - Hanna, Khalil

AU - Tseng, Scheffer C G

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N2 - Purpose: To determine whether preserved human amniotic membrane can reduce corneal haze and keratocyte apoptosis induced by excimer laser photoablation in rabbit corneas. Methods: Excimer photoablation was performed bilaterally in 30 rabbits with a 6.0 mm ablation zone and 120 μm depth using the VlSX Star laser with the phototherapeutic keratectomy (PTK) mode. One eye was randomly covered by preserved human amniotic membrane secured with 4 interrupted 10-0 nylon sutures, and the other eye served as the control. The amniotic membranes were removed at 1 week, and corneal haze was graded with slitlamp biomicroscopy by 3 masked corneal specialists biweekly for the ensuing 12 weeks until the rabbits were killed. Another 18 rabbits were divided into 4 subgroups and received PTK alone, PTK with membrane, PTK with sham sutures, or PTK with tarsorrhaphy. All eyes were studied histologically, and 3 eyes in each group were studied by in situ terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling assay at 1, 3, and 7 days and 12 weeks, respectively. Results: A consistent grading of differences in corneal haze scoring between the control corneas and the amniotic-membrane-covered corneas was noted among the 3 masked observers. Organized reticular post-PTK corneal haze peaked at 7 weeks in both groups, and the corneal haze score in the amniotic-membrane-covered group was significantly less than in the control group from 7 to 12 weeks (all P < .001). Compared to the control corneas, the amniotic-membrane-covered corneas had less inflammatory response at 1 and 3 days, less keratocyte apoptosis in the ablated anterior corneal stroma at 1, 3, and 7 days (P < .001), and less stromal fibroblast cellularity and epithelial hyperplasia at 12 weeks. Conclusions: Amniotic membrane matrix introduced at an early stage of the corneal wound healing process effectively reduced corneal haze induced by excimer laser photoablation in rabbits. Studies linking suppression of apoptosis in the acute wound-healing process with reduction of subsequent corneal scarring may have useful clinical applications.

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