Corneal Femtosecond Laser Keratotomy Results in Isolated Stromal Injury and Favorable Wound-Healing Response

Meltendorf, Christian; Burbach, Guido J.; Bühren, Jens; Bug, R.; Ohrloff, C.; Deller, Thomas

doi:10.1167/iovs.06-1150

Cited by 50 publications

(39 citation statements)

References 44 publications

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“…Both femtosecond laser (first set of experiments) and LASIK (second set of experiments) techniques are associated with a proper wound-healing response preserving corneal transparency and not eliciting differentiation of keratocytes into fibroblasts [53]. Whether or not perfect optic transparency is achieved, obtaining a cell source that can be committed to keratocytes and able to repopulate and regenerate cornea-like tissue, as found in our study, could be very valuable in situations compromising the stroma, such as corneal thinning diseases, traumatic loss of stromal tissue, or corneal damage after infection or immune response.…”

Section: Discussionmentioning

confidence: 99%

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Adipose-Derived Stem Cells Are a Source for Cell Therapy of the Corneal Stroma

et al. 2007

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Most corneal diseases affect corneal stroma and include immune or infectious diseases, ecstatic disorders, traumatic scars, and corneal dystrophies. Cell-based therapy is a promising therapeutic approach to overcome the current disadvantages of corneal transplantation. We intended to search for a cell source to repopulate and regenerate corneal stroma. We investigated the ability of human processed lipoaspirate derived (PLA) cells to regenerate corneal stroma in experimental animals. In the first set of experiments, we tested the biosafety and immunogenicity of human PLA stem cells transplanted into the corneal stroma of rabbits. No immune response was elicited even though we used immune-competent animals. PLA cells survived up to 10 weeks post-transplant, maintained their shape, and remained intermingled in the stroma without disrupting its histological pattern. Interestingly, transparency was preserved even 10 weeks after the transplant, when PLA cells formed a discontinuous layer in the stroma. In the second set of experiments, regeneration of the corneal stroma by PLA cells was assessed, creating a niche by partial ablation of the stroma. After 12 weeks, human cells were disposed following a multilayered pattern and differentiated into functional keratocytes, as assessed by the expression of aldehyde-3-dehydrogenase and cornea-specific proteoglycan keratocan. Based on our results, we believe that adipose-derived adult stem cells can be a cell source for stromal regeneration and repopulation in diseased corneas. The low health impact of the surgical procedure performed to obtain the PLA cells provides this cell source with an additional beneficial feature for its possible future autologous use in human patients.

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Section: Discussionmentioning

confidence: 99%

“…This model produces a favorable wound-healing response, preventing excessive inflammatory reaction [53], which may distort the stem cell behavior. The cornea is an external tissue suitable to stem cell therapy because of its easy accessibility by surgical maneuvers.…”

Section: Discussionmentioning

confidence: 99%

Adipose-Derived Stem Cells Are a Source for Cell Therapy of the Corneal Stroma

et al. 2007

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“…The findings by Zohdy et al that LIOB can be controlled to be thermally noninvasive, with a measurable temperature increase of less than 1°C in the vicinity of a femtosecond laser-generated bubble, are congruent with our observations of no discernable thermal collateral damage. Wang et al [8] using multiphoton microscopy technology and Meltendorf et al [9] in light and electron microscopy also found highly circumscribed injury to the corneal stroma limited to the target zone.…”

Section: Discussionmentioning

confidence: 97%

Structure of intracorneal femtosecond laser pulse effects in conical incision profiles

Vossmerbaeumer

Jonas

2008

Graefes Arch Clin Exp Ophthalmol

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At higher laser energies, the intrastromal laser lesions were larger and more confluent, suggesting that, with the prototype of femtosecond laser used, a higher laser energy may lead to more confluent intrastromal laser effects. It may facilitate the complete cutting of the corneal tissue with the laser. Neither discernable debris nor stainable collateral damage were detected, suggesting a purely mechanical action of the laser.

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“…The high energy generates tiny plasmas and vaporizes tissue at a given plane while leaving surrounding tissue intact. Using this approach, stromal photodisruption can be achieved without injuring the anterior and posterior epithelial layers of the cornea [6,7]. This "intrastromal laser surgery" is attractive because of its potential for minimizing wound-healing responses as well as reducing the risk of postoperative infection [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Using this approach, stromal photodisruption can be achieved without injuring the anterior and posterior epithelial layers of the cornea [6,7]. This "intrastromal laser surgery" is attractive because of its potential for minimizing wound-healing responses as well as reducing the risk of postoperative infection [7,8]. Previous experimental clinical studies have provided first evidence that the desired effect of central corneal thinning can be achieved by intrastromal photodisruption using pico-or femtosecond lasers [9][10][11].…”

Section: Introductionmentioning

confidence: 99%