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Correlations of Long-term Matrix Metalloproteinase Localization in Human Corneas After Successful Laser-Assisted In Situ Keratomileusis With Minor Complications at the Flap Margin
Pierre R. Fournié, MD;
Gabriel M. Gordon, BS;
Daniel G. Dawson, MD;
Henry F. Edelhauser, PhD;
M. Elizabeth Fini, PhD
Arch Ophthalmol. 2008;126(2):162-170.
Objective To determine whether matrix metalloproteinases (MMPs) are present long-term in human corneas after successful laser-assisted in situ keratomileusis (LASIK).
Methods Eighteen postmortem corneas from 10 patients with postoperative intervals of 2 to 8 years after LASIK surgery and 4 normal control corneas from 2 patients were collected from US eye banks and processed for histologic analysis and immunolocalization with antibodies to MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, and MMP-14.
Results Matrix metalloproteinase 7 was present in the epithelium of all corneas. Other MMPs were localized to the wound margin in some post-LASIK corneas. Matrix metalloproteinase 9 was detected around epithelial cells trapped in the lamellar scar in 5 of 6 corneas with epithelial ingrowth. Various MMPs were detected in fibrotic tissue at the wound margin in 2 of 2 corneas with flap retraction.
Conclusions The presence of MMPs in post-LASIK corneas correlates with an ongoing wound healing process associated with minor post-LASIK complications. Matrix metalloproteinases might contribute to instances of ongoing flap instability, and if so, judicious use of MMP inhibitors could provide benefit.
Author Affiliations: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Drs Fournié, Dawson, and Fini and Mr Gordon); Institut national de la santé et de la recherche médicale (INSERM), U563, Université Toulouse III Paul Sabatier, and Service dOphtalmologie, Hôpital Purpan, CHU Toulouse, Toulouse, France (Dr Fournié); and Emory Eye Center, Emory University, Atlanta, Georgia (Drs Dawson and Edelhauser).
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