Role of Cysteine in Corneal Wound Healing after Photorefractive Keratectomy

Meduri, Alessandro; Grenga, Pier Luigi; Scorolli, L.; Ceruti, Piero; Ferreri, Giuseppe

doi:10.1159/000187623

Cited by 24 publications

(17 citation statements)

References 65 publications

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“…The degree and extent of keratocyte apoptosis also varies with the type of overlying epithelial injury, and can be influenced by the surgical technique and drugs. [121314151617181920212223242526272829303132333435363738394041424344454647] Therefore, rapid re-epithelialization of the cornea would likely promote wound healing of the underlying stroma with minimal cell apoptosis. [38] Furthermore, the identification of factors that aid re-epithelialization after corneal epithelial injury and prevent complications related to delayed cicatrization, such as scar or haze formation, would optimize surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[383940] Several growth factors, vitamins and amino acids have also been shown to have a primary and active role in corneal re-epithelialization after corneal injury. [414243444546] These substances improve corneal haze and speed the complex process of corneal epithelial healing. [47]…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the efficacy of recombinant human b-FGF on epithelial healing has been demonstrated in rabbits after mechanical anterior keratectomy. [31323334354445]…”

Section: Discussionmentioning

confidence: 99%

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Effect of the combination of basic fibroblast growth factor and cysteine on corneal epithelial healing after photorefractive keratectomy in patients affected by myopia

Meduri

Scorolli

Scalinci

et al. 2014

Indian J Ophthalmol

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Background:This study sought to evaluate the effect of basic fibroblast growth factor eye drops and cysteine oral supplements on corneal healing in patients treated with photorefractive keratectomy (PRK).Materials and Methods:One hundred and twenty patients treated bilaterally with PRK for myopia were enrolled at one of two eye centers (Clinica Santa Lucia, Bologna, Italy and Department of Ophthalmology, University of Magna Graecia, Catanzaro, Italy) and were treated at the former center. Sixty patients included in the study group (Group 1) were treated postoperatively with topical basic fibroblast growth factor plus oral L-cysteine supplements, whereas 60 subjects included in the control group (Group 2) received basic fibroblast growth factor eye drops. We recorded the rate of corneal re-epithelialization and patients were followed-up every 30 days for 6 months. Statistical analyses were performed on the collected data.Results:The eyes in Group 1 demonstrated complete re-epithelialization at Day 5, whereas the eyes in Group 2 achieved this status on Day 6. No side-effects were reported.Conclusions:Patients treated with basic fibroblast growth factor eye drops and L-cysteine oral supplements benefit from more rapid corneal re-epithelialization. In human eyes, this combination treatment appeared to be safe and effective in accelerating corneal surfacing after surgery.Financial Disclosure:No author has any financial or proprietary interest in any material or method used in this study.Trial Registration:Current Controlled Trials ISRCTN73824458.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of the combination of basic fibroblast growth factor and cysteine on corneal epithelial healing after photorefractive keratectomy in patients affected by myopia

Meduri

Scorolli

Scalinci

et al. 2014

Indian J Ophthalmol

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“…Our previous data showed that topical bFGF and oral l-cysteine, alone [20,21] or in combination [22], were able to improve human corneal re-epithelization after the PRK surgery compared to untreated or to bFGF treatment, respectively. However, these studies did not test the effects of the treatments on the long term consequences of the accelerated re-epithelization, for example on the onset and/or the regression of corneal opacity.…”

Section: Discussionmentioning

confidence: 99%

Oral l-Cysteine Supplementation Enhances the Long Term-Effect of Topical Basic Fibroblast Growth Factor (bFGF) in Reducing the Corneal Haze after Photorefractive Keratectomy in Myopic Patients

et al. 2020

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We aimed at evaluating the long-term effects of l-cysteine oral supplementation to basic fibroblast growth factor (bFGF) eye-drops on corneal re-epithelization and transparency in myopic patients subjected to photorefractive keratectomy (PRK). Forty patients subjected to bilateral PRK for myopia were enrolled and randomly divided into two groups receiving an additional therapy together with the standard postoperative treatment consisting in local tobramycin 0.3%, dexamethasone 0.1%, diclofenac 0.1%, and 0.2% hyaluronate. Group 1 included 20 patients (11 males and 9 females; 34.09 ± 8 years of age) receiving only bFGF eye-drops (10 μg/10 μL) four times a day for 7 days starting from the day of surgery; Group 2 included 20 patients (12 males and 8 females; 37.35 ± 11.5 years of age) who were postoperatively administered with topical basic fibroblast growth factor (bFGF; 10 μg/10 μL) four times a day for 7 days plus oral l-cysteine supplementation (500 mg/capsule) once a day for 15 days, starting 7 days before PRK. Patients were followed-up for 12 months. Clinical ophthalmologic parameters were recorded for all the 80 examined eyes. The corneal transparency was evaluated in vivo by slit lamp and confocal microscopy. The data showed that: (a) the corneal haze occurred in a smaller percentage of the patients who were postoperatively administered with topical bFGF plus oral l-cysteine supplementation (Group 2) compared to patients who received only bFGF (Group 1); (b) at 6 months of follow-up, the stromal mean image brightness of the patients belonging to Group 2 was significantly lower than that of the Group 1 (p < 0.03), and, interestingly, the difference was even more evident at 12 month from the treatment (p < 0.001). Moreover, the final mean of the spherical equivalent refraction was −0.06 ± 0.2 D in Group 1 and −0.08 ± 0.3 D in Group 2, whereas the final uncorrected distance visual acuity (UDVA) was equal or superior to 20/25 in 100% of eyes in both Group 1 and 2. Post refractive patients can benefit from the administration of l-cysteine before the surgery and in association with bFGF in the early postoperative period, showing a faster corneal re-epithelization able to prevent corneal haze in the long-term recovery.

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“…9 However, cataract and elevated intraocular pressure are reported as adverse effects secondary to the use of steroidal agents. 10–21 As alternatives to steroid therapy, studies have evaluated the effects of nonsteroidal antiinflammatory agents, 22–25 tranilast, 26 cysteine, 27 and antioxidants such as vitamin E, among others. 28 …”

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confidence: 99%

Reducing peak corneal haze after photorefractive keratectomy in rabbits: Prednisolone acetate 1.00% versus cyclosporine A 0.05%

Nien

Flynn

Chang

et al. 2011

Journal of Cataract and Refractive Surgery

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PURPOSE To compare the effects of topical cyclosporine A 0.05% (Restasis) with those of prednisolone acetate 1.00% (Pred Forte) on corneal haze after photorefractive keratectomy (PRK). SETTING Gavin Herbert Eye Institute, University of California, Irvine–Orange, California, USA. DESIGN Experimental study. METHODS After −9.00 diopter PRK, 15 rabbits were divided into 3 groups and treated for 4 weeks with prednisolone acetate 1.00% or cyclosporine A 0.05% or neither (control). Corneal haze was measured by in vivo confocal microscopy preoperatively and 2, 4, 6, 8, and 12 weeks postoperatively. At 12 weeks, the corneas were evaluated for collagen organization by ex vivo 2-photon second-harmonic generation and stromal cell density. RESULTS Corneal haze was significantly less in the prednisolone acetate group than in the cyclosporine and control groups during the first 6 weeks postoperatively (P < .02). At 8 weeks, there was no significant difference between the 3 groups. There was no significant difference in haze between the cyclosporine group and control group at any time. The stroma was also significantly thinner in the prednisolone acetate group than in the other groups for the first 4 weeks postoperatively (P < .02). Second-harmonic generation scar thickness measurements at 12 weeks were not significantly different between the groups, although the prednisolone acetate group tended to have lower stromal cell density. CONCLUSION Cyclosporine A 0.05% had no effect on wound healing after PRK, while prednisolone acetate 1.00% significantly reduced peak corneal haze but had no effect on long-term corneal haze after discontinuation of the drug.

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Role of Cysteine in Corneal Wound Healing after Photorefractive Keratectomy

Cited by 24 publications

References 65 publications

Effect of the combination of basic fibroblast growth factor and cysteine on corneal epithelial healing after photorefractive keratectomy in patients affected by myopia

Effect of the combination of basic fibroblast growth factor and cysteine on corneal epithelial healing after photorefractive keratectomy in patients affected by myopia

Oral l-Cysteine Supplementation Enhances the Long Term-Effect of Topical Basic Fibroblast Growth Factor (bFGF) in Reducing the Corneal Haze after Photorefractive Keratectomy in Myopic Patients

Reducing peak corneal haze after photorefractive keratectomy in rabbits: Prednisolone acetate 1.00% versus cyclosporine A 0.05%

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