Intact corneal epithelium is essential for the prevention of stromal haze after laser assisted in situ keratomileusis

Nakamura, Kiyoji

doi:10.1136/bjo.85.2.209

Cited by 99 publications

(52 citation statements)

References 25 publications

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“…These cells are reported to have extensive differentiation capacities in a variety of tissues, including those of the eye. Specifically in the cornea, "wandering cells" have been detected in the stroma that are believed to be BM derived antigen presenting stem cells from different lineages such as dendritic cells and macrophages (Nakamura, Kurosaka, Bissen-Miyajima, & Tsubota, 2001). It has been postulated that the "wandering cells" within the stroma could be important in releasing factors that aid in the activation of the keratocytes following injury (Fini & Stramer, 2005;Hennessy, Korbling, & Estrov, 2004).…”

Section: Stem Cells In the Corneal Stromamentioning

confidence: 99%

The keratocyte: Corneal stromal cell with variable repair phenotypes

West‐Mays

Dwivedi

2006

The International Journal of Biochemistry & Cell Biology

319

223

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Keratocytes, also known as fibroblasts, are mesencyhmal-derived cells of the corneal stroma. These cells are normally quiescent, but they can readily respond and transition into repair phenotypes following injury. Cytokines and other growth factors that provide autocrine signals for stimulating wound responses in resident cells are typically presented by platelets at the site of an injury. However, due to the avascular nature of the cornea many of the environmental cues are derived from the overlying epithelium. Corneal epithelial-keratocyte cell interactions have thus been extensively studied in numerous in vivo corneal wound healing settings, as well as in in vitro culture models. Exposure to the different epithelial-derived factors, as well as the integrity of the epithelial substratum, are factors known to impact the keratocyte response and determine whether corneal repair will be regenerative or fibrotic in nature. Finally, the recent identification of bone-marrow derived stem cells in the corneal stroma suggests a further complexity in the regulation of the keratocyte phenotype following injury. KeywordsKeratocyte; Cornea; Injury; Apoptosis; Myofibroblasts; Transparency; Plasticity Cell facts• Keratocytes are neural-crest derived mesenchymal cells that sparsely populate the corneal stroma.• Keratocytes are quiescent, dendritic cells that upon injury to the cornea are stimulated to either undergo apoptosis or transition into repair phenotypes.• Structural integrity of the basement membrane is critical for minimizing the fibrotic response of keratocytes and subsequent scarring and loss of corneal clarity.• Bone-marrow derived stem cells have been detected in the corneal stroma and may participate in the activation of the keratocytes following injury.

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Section: Stem Cells In the Corneal Stromamentioning

confidence: 99%

The keratocyte: Corneal stromal cell with variable repair phenotypes

West‐Mays

Dwivedi

2006

The International Journal of Biochemistry & Cell Biology

319

223

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“…Studies of complications after LASEK have focused on haze formation (Nakamura et al, 2001;Lin et al, 2004;Long et al, 2006;Thornton et al, 2007), but there are few reports describing epithelial complications. Using confocal microscopy, we observed the abnormal epithelial region after LASEK, which not only included the epithelial cell layer, but also the poor regeneration of the sub-basal nerve plexus.…”

Section: Discussionmentioning

confidence: 99%

Characterization of abnormal epithelium after laser-assisted subepithelial keratectomy using in vivo confocal microscopy

Zuo¹,

Cw²,

Zhou³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. This study compared the abnormal corneal epithelium after laser-assisted subepithelial keratectomy (LASEK) with dystrophic cornea using in vivo using confocal microscopy (IVCM) and examined the effects of the abnormal epithelium on postoperative recovery of uncorrected distance visual acuity (UDVA) and sub-basal nerve plexus regeneration. The UDVA and wound healing were examined in 50 eyes of 25 patients undergoing LASEK at 1 week, 1 month, and 1 year postoperatively, including the visual acuity, slit lamp microscopy, and IVCM. After 1 week, the corneal epithelium was healed in all patients, but abnormal epithelial cells were detected in 33/50 patients using IVCM. Abnormal cells were limited to the surgical margin, and highly reflective granules were observed underneath. At 1 month and 1 year postoperatively, the abnormal epithelium was unchanged in size. At 1 year postoperatively, there were clear differences between the sub-basal nerve plexus in the normal and abnormal epithelium. At 1 J. Zuo et al. 4750©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 4749-4756 (2015) month postoperatively, the UDVA was >1.0 in 88% of patients, which increased to 94% at 1 year, and there was no clear difference in the UDVA between abnormal (N = 33) and normal (N = 17) epithelium. After LASEK, abnormal epithelial cells may arise at the margin of the epithelial flap and persist 1 year postoperatively accompanied by poor regeneration of the sub-basal nerve plexus. However, this does not affect the UDVA postoperatively. The abnormal epithelium may be caused by residual necrotic basal cell debris on the epithelial basement membrane and abnormal neurotrophic metabolism between the corneal epithelium and nerve plexus.

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“…Cases of stromal haze were reported 1 to 9 months after LASIK surgery or retreatment [27][28][29][30]. However, 55.6% of eyes had previous diffuse lamellar keratopathy (DLK) on the fi rst postoperative day and no patient had lost lines of BCVA or complained of reduced vision [27].…”

Section: Discussionmentioning

confidence: 99%

“…However, 55.6% of eyes had previous diffuse lamellar keratopathy (DLK) on the fi rst postoperative day and no patient had lost lines of BCVA or complained of reduced vision [27]. Severe haze was reported after LASIK in cases with previous PRK and vice versa [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Late Onset Flap Scarring After Laser in Situ Keratomileusis

Orucoglu

2011

J Med Cases

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A 55 year old man had uneventful simultaneous LASIK. Seven months postoperatively, the patient came with complaints of a decrease in vision, photophobia, tearing, discomfort, and red eye during the last 2 weeks in the left eye. Suspicion was foreign body hit. Despite steroid treatment, the clinical outcome didn't improve. Eight months postoperatively, slit-lamp examination revealed thinning and scarring in the center of the fl ap in the central cornea. The left eye's best corrected visual acuity was 20/32. The patient underwent a surgical procedure of trephining of the scarred fl ap and using Mitomycin C 0.02%. At the fi nal examination after 18 months the BCVA was 20/25. This is the fi rst report on late central corneal scarring after LASIK. Trephinization of the scarred fl ap can restore visual acuity.

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Intact corneal epithelium is essential for the prevention of stromal haze after laser assisted in situ keratomileusis

Cited by 99 publications

References 25 publications

The keratocyte: Corneal stromal cell with variable repair phenotypes

The keratocyte: Corneal stromal cell with variable repair phenotypes

Characterization of abnormal epithelium after laser-assisted subepithelial keratectomy using in vivo confocal microscopy

Late Onset Flap Scarring After Laser in Situ Keratomileusis

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