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Terrence P. O'Brien, MD; Qian Li, MD; M. Farooq Ashraf, MD; Dawn M. Matteson, MS; Walter J. Stark, MD; Chi-Chao Chan, MD

Arch Ophthalmol. 1998;116:1470-1474.

Objective  To evaluate the inflammatory response and its potential role in the early stages of corneal wound healing after excimer laser keratectomy.

Materials and Methods  Lewis rats underwent excimer keratectomy using a 193-nm excimer laser. The central corneas were ablated in 3 depths: group A, epithelium; group B, superficial stroma; or group C, deep stroma. Eyes were harvested 1, 12, 24, and 36 hours, and 1 week after the rats were killed. Immunohistochemistry was used to test frozen sections with monoclonal antibodies of various inflammatory cellular markers.

Results  Reepithelialization was observed at 12 hours in group A, and at 24 hours in groups B and C. Regenerated epithelium covered the denuded corneal surface in groups B and C after 1 week. The expression of major histocompatibility complex II antigen was detected in infiltrating cells, corneal epithelial cells, and endothelial cells 1 hour after surgery. Only a few macrophages and Langerhans cells were in the limbus at baseline. Macrophages migrated from the limbus to the corneal ablation zone and increased 2-fold after 36 hours in all 3 groups compared with baseline. Occasional lymphocytic infiltration was identified after 25 to 36 hours.

Conclusion  Macrophages play an active role in the wound healing after laser keratectomy and may contribute to transient corneal haze.

From the Cornea Service, Wilmer Eye Institute, The Johns Hopkins University, Baltimore, Md (Drs O'Brien, Li, Ashraf, and Stark); and the Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Md (Drs Li and Chan and Ms Matteson).

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