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Re-epithelialization in Cornea Organ Culture After Chemical Burns and Excimer Laser Treatment
Roy S. Chuck, MD, PhD;
Ashley Behrens, MD;
Sarah Wellik, MD;
Leacky L. H. Liaw, MS;
Arlene M. T. Dolorico, MD;
Paula Sweet, MT;
Lawrence C. Chao, MD;
Kathryn E. Osann, PhD;
Peter J. McDonnell, MD;
Michael W. Berns, PhD
Arch Ophthalmol. 2001;119:1637-1642.
Objective To describe the epithelial healing rates observed in freshly cultured rabbit corneas chemically burned with high-concentration hydrochloric acid (HCl) and sodium hydroxide (NaOH) and subsequently treated with phototherapeutic keratectomy (PTK).
Methods We obtained 126 fresh corneoscleral rims from cadaveric New Zealand white rabbits. Each cornea was exposed to 4-mm cellulose sponges soaked in a solution of topical 0.9% isotonic sodium chloride solution, 2M HCl, or 0.5M NaOH. A transepithelial PTK (6-mm zone; 100-µm ablation depth) was then performed using the excimer laser (150-mJ/cm2 energy pulse; 20 nanosecond duration; and 10-Hz frequency). Corneas were placed in tissue culture, and 1 cornea from each group was taken out of culture each day after treatment. Re-epithelialization was monitored by means of fluorescein staining, slitlamp photography, and histopathological analysis.
Results Corneas treated with HCl and NaOH exhibited immediate epithelial defects that slowly healed over time. In PTK-treated corneas, the re-epithelialization rate was accelerated compared with that of controls (P = .003 for the HCl group, and P<.001 for the NaOH group). The new epithelial layers were smoother in PTK-treated corneas, as confirmed by results of histopathological analysis.
Conclusion Corneal damage caused by HCl and NaOH may be modulated in vitro by PTK in this rabbit model.
Clinical Relevance After corneal chemical damage, 193-nm excimer laser PTK accelerates epithelial wound healing.
From the Departments of Ophthalmology (Drs Chuck, Behrens, Wellik, Dolorico, Chao, and McDonnell and Ms Sweet), Medicine (Dr Osann), and Cell Biology and Surgery (Dr Berns), University of California–Irvine, and Beckman Laser Institute and Medical Clinic (Drs Chuck, Chao, and Berns and Ms Liaw), Irvine, Calif; and Doheny Eye Institute, University of Southern California, Los Angeles (Drs Behrens and McDonnell). The authors have no commercial or proprietary interests in any of the devices and materials used in this study.
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Carrier et al.
IOVS 2008;49:1376-1385.
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