Increased release of tenascin in tear fluid after photorefractive keratectomy

Vesaluoma, Minna; Ylätupa, Sari; Mertaniemi, Päivi; Tervo, Kaarina; Partanen, Pirjo; Tervo, Timo

doi:10.1007/bf00183428

Cited by 28 publications

(20 citation statements)

References 22 publications

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“…15 The directional migration and accumulation of leucocytes next to the LASIK flap edge suggest that proinflammatory cytokines and chemokines are present in this region. Evidence of such signalling molecules has been found in the tear fluid, 16 epithelium, 17 18 and in keratocytes. 18 19 By contrast, the lack of leucocytes at the LASIK interface may indicate that an isolated stromal injury induces less of a chemotactic signal than when the epithelium and its basement membrane are involved.…”

Section: Discussionmentioning

confidence: 99%

“…20 In the intact cornea, the epithelial basement membrane has been reported to bind cytokines, 21 22 suggesting that it may act as a barrier for signaling molecules from the epithelium or tear fluid. 23 Thus, when the basement membrane integrity is compromised at the LASIK flap edge, signalling molecules with mitogenic and chemotactic effect on keratocytes 22 24 25 and inflammatory cells [16][17][18] may enter the stroma. The present finding of directional cell migration and localised activation of keratocytes (between the breaks in the basement membrane) supports this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

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Characterisation of corneal fibrotic wound repair at the LASIK flap margin

Ivarsen

Laurberg²,

Møller‐Pedersen³

2003

British Journal of Ophthalmology

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Aim: To characterise temporal changes in corneal wound repair at the LASIK flap margin. Methods: 18 rabbits received monocular LASIK and were evaluated during 6 months using slit lamp and in vivo confocal microscopy. In three corneas, the exposed stroma was stained with DTAF. At various time points, corneas were processed for histology and stained for nuclei, f-actin, ED-A fibronectin, a-smooth muscle actin, TGF-b1, TGF-b2, TGF-b receptor II, and CTGF. Results: At day 1, leucocytes migrated from the conjunctival vessels into the cornea. Near the limbus, the leucocytes were organised in long chains stretching towards the flap edge. From day 4, elongated fibroblasts migrated from the periphery to align in a circumferential band (approximately 250 mm wide) next to the flap edge. The lateral extension of this stromal band was delimited by the incisional gap in the epithelial basement membrane. TGF-b1, TGF-b2, TGF-b receptor II, and CTGF were expressed in the band from day 2. Myofibroblasts were identified at week 3 and over time a 50 mm thick layer of fibrotic matrix was deposited. Concurrently, the peripheral circumferential band became narrower (width decreasing to 33% (SD 7%) at 4 months; n = 5) and showed an increased organisation with a gradual decline in reflectivity. At all time points, keratocytes within and below the flap remained quiescent and only minimal fibrosis developed at the interface. Conclusions: Fibrotic wound repair following LASIK is restricted to a narrow band peripheral to the corneal flap edge. The lateral extension of the fibrosis is sharply delimited by the incisional gap in the epithelial basement membrane. The fibrotic wound healing at the LASIK flap margin is associated with myofibroblast transformation and wound contraction and involves a TGF-b signalling pathway. L aser in situ keratomileusis (LASIK) is a modern refractive surgical procedure that involves temporary displacement of a hinged corneal tissue flap during laser treatment of the underlying stromal bed. LASIK is associated with a high risk of complications related to the corneal flap including epithelial ingrowth, flap melting, and traumatic flap dislocation.1-4 These complications may be related to the clinically observed lack of corneal wound healing that allows the corneal flap to be separated from its stromal bed for an indeterminate time after surgery. Thus, the LASIK interface is readily accessible for re-treatment more than 1 year after the initial procedure, 5 and corneal flap dehiscence has been observed several years after uneventful surgery. 4 Using slit lamp biomicroscopy, a white reflecting band is typically observed in the corneal flap periphery after LASIK (Fig 1). 2 6 Over time, this circumferential band undergoes characteristic changes in width, texture, and reflectivity. The band is generally believed to represent corneal wound healing 2 7-10 ; however, its exact nature, localisation, and significance have not been thoroughly investigated. Using a rabbit eye model, the present study characterises temporal ch...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characterisation of corneal fibrotic wound repair at the LASIK flap margin

Ivarsen

Laurberg²,

Møller‐Pedersen³

2003

British Journal of Ophthalmology

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“…The morphologic changes induced by myopic LASIK in human corneal stroma have been extensively characterized by confocal microscopy and histological studies. [2][3][4]10,[23][24] Analysis of extracellular matrix proteins and cytokines in tear fluid after PRK showed increased levels of tenascin, TNF-a, and several growth factors, [12][13][14][15][25][26] suggesting that growth-modulating cytokines may be involved in healing processes. Laser in situ keratomileusis and laser-assisted subepithelial keratectomy seem to be less traumatic than PRK because a lower amount of tear transforming growth factor (TGF-b) is released and expressed in the early postoperative days than in PRK, [27][28][29] indicating that different techniques stimulate different corneal cell activation.…”

Section: Discussionmentioning

confidence: 99%

Cytokine and chemokine levels in tears and in corneal fibroblast cultures before and after excimer laser treatment

Leonardi¹,

Tavolato²,

Curnow³

et al. 2009

Journal of Cataract and Refractive Surgery

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“…Cultured rabbit corneal ®broblasts synthesize and secrete ®bronectin (Fukuda et al, 1988). Tears have been shown to contain substantial amounts of ®bronectin and tenascin following photorefractive keratectomy (Vesaluoma et al, 1995;Virtanen et al, 1995). Both cellular and plasma ®bronectin have been found in the tears (Virtanen et al, 1995;Fukuda et al, 1996) and may originate from lacrimal gland secretion and from passive conjunctival vessel leakage.…”

Section: Fibronectin and Tenascinmentioning

confidence: 96%