Excimer laser effects on human corneal endothelium. Modulation by serum factor(s)
R. W. Lambert, J. A. Anderson, J. Heitzmann, C. J. Sutherland, M. M. Moore and P. S. Binder
National Vision Research Institute, San Diego, Calif, USA.
OBJECTIVE: To determine the possibility of endothelial cell damage after
excimer laser ablation. METHODS: Endothelial cell densities and morphology
of human corneas after photoablations or mechanical keratectomy were
compared with those of the untreated mates after 1 week of culture with or
without serum. RESULTS: Corneas cultured in serum-free medium after
ablation to a depth of 150 microns showed endothelial cell densities
reduced to 60% of untreated, mate corneas; ultrastructural analysis showed
endothelial cell damage not seen in untreated mates. Corneas ablated to the
same depth and cultured in serum-enriched medium showed no endothelial cell
density loss, nor did corneas cultured in serum-free medium after an
ablation to a depth of 50 microns or mechanical keratectomies averaging 95
microns. CONCLUSIONS: Endothelial cell loss in deep laser resections may be
prevented by factor(s) in fetal bovine serum. The apparent lack of cell
loss in clinical studies may be related to the protective action of similar
factors in aqueous humor.
