Histological changes and wound healing response following noncontact holmium: YAG laser thermal keratoplasty.
Identifieur interne : 000186 ( Pmc/Corpus ); précédent : 000185; suivant : 000187Histological changes and wound healing response following noncontact holmium: YAG laser thermal keratoplasty.
Auteurs : D D KochSource :
- Transactions of the American Ophthalmological Society [ 0065-9533 ] ; 1996.
Abstract
PURPOSE: To evaluate acute histological changes and the induced wound healing response in corneal tissue following noncontact holmium:YAG laser thermal keratoplasty (LTK). METHODS: LTK using 10 pulses and a range of radiant energies was performed on 3 human corneas one day prior ro their removal at penetrating keratoplasty. Rabbit corneas were treated with 10-pulse and 5-pulse LTK and followed for up to 3 months. Tissues were studies with light and transmission electron microscopy and immunohistochemistry. RESULTS: The amount of acute tissue injury increased with increasing pulse radiant energy. In human corneas, changes in the irradiated zones included epithelial cell injury and death loss of fine filamentous structure in Bowman's layer, disruption of stromal lamallae, and keratocyte injury and death. In the rabbit corneas, similar acute changes were noted. By 3 weeks, epithelial hyperplasia and stromal contraction were present. Wound healing in the rabbit corneas included repair of the epithelial attachment complex, keratocyte activation, synthesis of type I collagen, partial restoration of stromal keratan sulfate and type VI collagen, and retrocorneal membrane formation. Compared to 10-pulse treatments, 5-pulse treatments produced less acute tissue injury and had more rapid restoration of normal stromal architecture. CONCLUSION: Noncontact LTK produces acute epithelial and stromal tissue changes and in rabbit corneas stimulates a brisk wound healing response. These changes could contribute to postoperative regression of induced refractive correction. Further work is required to determine if reductions in the magnitude of acute tissue injury and induced wound healing response will enhance the efficacy and stability of LTK.
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PubMed: 8981715
PubMed Central: 1312114
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Histological changes and wound healing response following noncontact holmium: YAG laser thermal keratoplasty.</title><author><name sortKey="Koch, D D" sort="Koch, D D" uniqKey="Koch D" first="D D" last="Koch">D D Koch</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">8981715</idno><idno type="pmc">1312114</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312114</idno><idno type="RBID">PMC:1312114</idno><date when="1996">1996</date><idno type="wicri:Area/Pmc/Corpus">000186</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000186</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Histological changes and wound healing response following noncontact holmium: YAG laser thermal keratoplasty.</title><author><name sortKey="Koch, D D" sort="Koch, D D" uniqKey="Koch D" first="D D" last="Koch">D D Koch</name></author></analytic><series><title level="j">Transactions of the American Ophthalmological Society</title><idno type="ISSN">0065-9533</idno><idno type="eISSN">1545-6110</idno><imprint><date when="1996">1996</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>PURPOSE: To evaluate acute histological changes and the induced wound healing response in corneal tissue following noncontact holmium:YAG laser thermal keratoplasty (LTK). METHODS: LTK using 10 pulses and a range of radiant energies was performed on 3 human corneas one day prior ro their removal at penetrating keratoplasty. Rabbit corneas were treated with 10-pulse and 5-pulse LTK and followed for up to 3 months. Tissues were studies with light and transmission electron microscopy and immunohistochemistry. RESULTS: The amount of acute tissue injury increased with increasing pulse radiant energy. In human corneas, changes in the irradiated zones included epithelial cell injury and death loss of fine filamentous structure in Bowman's layer, disruption of stromal lamallae, and keratocyte injury and death. In the rabbit corneas, similar acute changes were noted. By 3 weeks, epithelial hyperplasia and stromal contraction were present. Wound healing in the rabbit corneas included repair of the epithelial attachment complex, keratocyte activation, synthesis of type I collagen, partial restoration of stromal keratan sulfate and type VI collagen, and retrocorneal membrane formation. Compared to 10-pulse treatments, 5-pulse treatments produced less acute tissue injury and had more rapid restoration of normal stromal architecture. CONCLUSION: Noncontact LTK produces acute epithelial and stromal tissue changes and in rabbit corneas stimulates a brisk wound healing response. These changes could contribute to postoperative regression of induced refractive correction. Further work is required to determine if reductions in the magnitude of acute tissue injury and induced wound healing response will enhance the efficacy and stability of LTK.</p><sec sec-type="scanned-figures"><title>Images</title><fig id="F1"><label>FIGURE 1A</label><graphic xlink:href="taos00005-0764-a" xlink:role="749"></graphic></fig><fig id="F2"><label>FIGURE 1B</label><graphic xlink:href="taos00005-0765-a" xlink:role="750"></graphic></fig><fig id="F3"><label>FIGURE 2A</label><graphic xlink:href="taos00005-0767-a" xlink:role="752"></graphic></fig><fig id="F4"><label>FIGURE 2B</label><graphic xlink:href="taos00005-0767-b" xlink:role="752"></graphic></fig><fig id="F5"><label>FIGURE 3A</label><graphic xlink:href="taos00005-0775-a" xlink:role="760"></graphic></fig><fig id="F6"><label>FIGURE 3B</label><graphic xlink:href="taos00005-0776-a" xlink:role="761"></graphic></fig><fig id="F7"><label>FIGURE 4A</label><graphic xlink:href="taos00005-0777-a" xlink:role="762"></graphic></fig><fig id="F8"><label>FIGURE 4B</label><graphic xlink:href="taos00005-0778-a" xlink:role="763"></graphic></fig><fig id="F9"><label>FIGURE 4C</label><graphic xlink:href="taos00005-0779-a" xlink:role="764"></graphic></fig><fig id="F10"><label>FIGURE 4D</label><graphic xlink:href="taos00005-0779-b" xlink:role="764"></graphic></fig><fig id="F11"><label>FIGURE 5A</label><graphic xlink:href="taos00005-0780-a" xlink:role="765"></graphic></fig><fig id="F12"><label>FIGURE 5B</label><graphic xlink:href="taos00005-0780-b" xlink:role="765"></graphic></fig><fig id="F13"><label>FIGURE 5C</label><graphic xlink:href="taos00005-0781-a" xlink:role="766"></graphic></fig><fig id="F14"><label>FIGURE 5D</label><graphic xlink:href="taos00005-0781-b" xlink:role="766"></graphic></fig><fig id="F15"><label>FIGURE 6A</label><graphic xlink:href="taos00005-0784-a" xlink:role="769"></graphic></fig><fig id="F16"><label>FIGURE 6B</label><graphic xlink:href="taos00005-0784-b" xlink:role="769"></graphic></fig><fig id="F17"><label>FIGURE 6C</label><graphic xlink:href="taos00005-0785-a" xlink:role="770"></graphic></fig><fig id="F18"><label>FIGURE 6D</label><graphic xlink:href="taos00005-0785-b" xlink:role="770"></graphic></fig><fig id="F19"><label>FIGURE 7A</label><graphic xlink:href="taos00005-0786-a" xlink:role="771"></graphic></fig><fig id="F20"><label>FIGURE 7B</label><graphic xlink:href="taos00005-0786-b" xlink:role="771"></graphic></fig><fig id="F21"><label>FIGURE 8A</label><graphic xlink:href="taos00005-0787-a" xlink:role="772"></graphic></fig><fig id="F22"><label>FIGURE 8B</label><graphic xlink:href="taos00005-0787-b" xlink:role="772"></graphic></fig><fig id="F23"><label>FIGURE 8C</label><graphic xlink:href="taos00005-0788-a" xlink:role="773"></graphic></fig><fig id="F24"><label>FIGURE 9A</label><graphic xlink:href="taos00005-0789-a" xlink:role="774"></graphic></fig><fig id="F25"><label>FIGURE 9B</label><graphic xlink:href="taos00005-0789-b" xlink:role="774"></graphic></fig><fig id="F26"><label>FIGURE 10A</label><graphic xlink:href="taos00005-0790-a" xlink:role="775"></graphic></fig><fig id="F27"><label>FIGURE 10B</label><graphic xlink:href="taos00005-0790-b" xlink:role="775"></graphic></fig><fig id="F28"><label>FIGURE 11</label><graphic xlink:href="taos00005-0791-a" xlink:role="776"></graphic></fig><fig id="F29"><label>FIGURE 12A</label><graphic xlink:href="taos00005-0792-a" xlink:role="777"></graphic></fig><fig id="F30"><label>FIGURE 12B</label><graphic xlink:href="taos00005-0793-a" xlink:role="778"></graphic></fig><fig id="F31"><label>FIGURE 12C</label><graphic xlink:href="taos00005-0793-b" xlink:role="778"></graphic></fig><fig id="F32"><label>FIGURE 12D</label><graphic xlink:href="taos00005-0794-a" xlink:role="779"></graphic></fig><fig id="F33"><label>FIGURE 13A</label><graphic xlink:href="taos00005-0795-a" xlink:role="780"></graphic></fig><fig id="F34"><label>FIGURE 13B</label><graphic xlink:href="taos00005-0795-b" xlink:role="780"></graphic></fig><fig id="F35"><label>FIGURE 14A</label><graphic xlink:href="taos00005-0796-a" xlink:role="781"></graphic></fig><fig id="F36"><label>FIGURE 14B</label><graphic xlink:href="taos00005-0796-b" xlink:role="781"></graphic></fig><fig id="F37"><label>FIGURE 15A</label><graphic xlink:href="taos00005-0797-a" xlink:role="782"></graphic></fig><fig id="F38"><label>FIGURE 15B</label><graphic xlink:href="taos00005-0799-a" xlink:role="784"></graphic></fig><fig id="F39"><label>FIGURE 15C</label><graphic xlink:href="taos00005-0800-a" xlink:role="785"></graphic></fig><fig id="F40"><label>FIGURE 15D</label><graphic xlink:href="taos00005-0801-a" xlink:role="786"></graphic></fig><fig id="F41"><label>FIGURE 16A</label><graphic xlink:href="taos00005-0802-a" xlink:role="787"></graphic></fig><fig id="F42"><label>FIGURE 16B</label><graphic xlink:href="taos00005-0803-a" xlink:role="788"></graphic></fig><fig id="F43"><label>FIGURE 16C</label><graphic xlink:href="taos00005-0804-a" xlink:role="789"></graphic></fig><fig id="F44"><label>FIGURE 16D</label><graphic xlink:href="taos00005-0805-a" xlink:role="790"></graphic></fig></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Trans Am Ophthalmol Soc</journal-id><journal-title>Transactions of the American Ophthalmological Society</journal-title><issn pub-type="ppub">0065-9533</issn><issn pub-type="epub">1545-6110</issn></journal-meta><article-meta><article-id pub-id-type="pmid">8981715</article-id><article-id pub-id-type="pmc">1312114</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Histological changes and wound healing response following noncontact holmium: YAG laser thermal keratoplasty.</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Koch</surname><given-names>D D</given-names></name></contrib></contrib-group><pub-date pub-type="ppub"><year>1996</year></pub-date><volume>94</volume><fpage>745</fpage><lpage>802</lpage><abstract><p>PURPOSE: To evaluate acute histological changes and the induced wound healing response in corneal tissue following noncontact holmium:YAG laser thermal keratoplasty (LTK). METHODS: LTK using 10 pulses and a range of radiant energies was performed on 3 human corneas one day prior ro their removal at penetrating keratoplasty. Rabbit corneas were treated with 10-pulse and 5-pulse LTK and followed for up to 3 months. Tissues were studies with light and transmission electron microscopy and immunohistochemistry. RESULTS: The amount of acute tissue injury increased with increasing pulse radiant energy. In human corneas, changes in the irradiated zones included epithelial cell injury and death loss of fine filamentous structure in Bowman's layer, disruption of stromal lamallae, and keratocyte injury and death. In the rabbit corneas, similar acute changes were noted. By 3 weeks, epithelial hyperplasia and stromal contraction were present. Wound healing in the rabbit corneas included repair of the epithelial attachment complex, keratocyte activation, synthesis of type I collagen, partial restoration of stromal keratan sulfate and type VI collagen, and retrocorneal membrane formation. Compared to 10-pulse treatments, 5-pulse treatments produced less acute tissue injury and had more rapid restoration of normal stromal architecture. CONCLUSION: Noncontact LTK produces acute epithelial and stromal tissue changes and in rabbit corneas stimulates a brisk wound healing response. These changes could contribute to postoperative regression of induced refractive correction. Further work is required to determine if reductions in the magnitude of acute tissue injury and induced wound healing response will enhance the efficacy and stability of LTK.</p><sec sec-type="scanned-figures"><title>Images</title><fig id="F1"><label>FIGURE 1A</label><graphic xlink:href="taos00005-0764-a" xlink:role="749"></graphic></fig><fig id="F2"><label>FIGURE 1B</label><graphic xlink:href="taos00005-0765-a" xlink:role="750"></graphic></fig><fig id="F3"><label>FIGURE 2A</label><graphic xlink:href="taos00005-0767-a" xlink:role="752"></graphic></fig><fig id="F4"><label>FIGURE 2B</label><graphic xlink:href="taos00005-0767-b" xlink:role="752"></graphic></fig><fig id="F5"><label>FIGURE 3A</label><graphic xlink:href="taos00005-0775-a" xlink:role="760"></graphic></fig><fig id="F6"><label>FIGURE 3B</label><graphic xlink:href="taos00005-0776-a" xlink:role="761"></graphic></fig><fig id="F7"><label>FIGURE 4A</label><graphic xlink:href="taos00005-0777-a" xlink:role="762"></graphic></fig><fig id="F8"><label>FIGURE 4B</label><graphic xlink:href="taos00005-0778-a" xlink:role="763"></graphic></fig><fig id="F9"><label>FIGURE 4C</label><graphic xlink:href="taos00005-0779-a" xlink:role="764"></graphic></fig><fig id="F10"><label>FIGURE 4D</label><graphic xlink:href="taos00005-0779-b" xlink:role="764"></graphic></fig><fig id="F11"><label>FIGURE 5A</label><graphic xlink:href="taos00005-0780-a" xlink:role="765"></graphic></fig><fig id="F12"><label>FIGURE 5B</label><graphic xlink:href="taos00005-0780-b" xlink:role="765"></graphic></fig><fig id="F13"><label>FIGURE 5C</label><graphic xlink:href="taos00005-0781-a" xlink:role="766"></graphic></fig><fig id="F14"><label>FIGURE 5D</label><graphic xlink:href="taos00005-0781-b" xlink:role="766"></graphic></fig><fig id="F15"><label>FIGURE 6A</label><graphic xlink:href="taos00005-0784-a" xlink:role="769"></graphic></fig><fig id="F16"><label>FIGURE 6B</label><graphic xlink:href="taos00005-0784-b" xlink:role="769"></graphic></fig><fig id="F17"><label>FIGURE 6C</label><graphic xlink:href="taos00005-0785-a" xlink:role="770"></graphic></fig><fig id="F18"><label>FIGURE 6D</label><graphic xlink:href="taos00005-0785-b" xlink:role="770"></graphic></fig><fig id="F19"><label>FIGURE 7A</label><graphic xlink:href="taos00005-0786-a" xlink:role="771"></graphic></fig><fig id="F20"><label>FIGURE 7B</label><graphic xlink:href="taos00005-0786-b" xlink:role="771"></graphic></fig><fig id="F21"><label>FIGURE 8A</label><graphic xlink:href="taos00005-0787-a" xlink:role="772"></graphic></fig><fig id="F22"><label>FIGURE 8B</label><graphic xlink:href="taos00005-0787-b" xlink:role="772"></graphic></fig><fig id="F23"><label>FIGURE 8C</label><graphic xlink:href="taos00005-0788-a" xlink:role="773"></graphic></fig><fig id="F24"><label>FIGURE 9A</label><graphic xlink:href="taos00005-0789-a" xlink:role="774"></graphic></fig><fig id="F25"><label>FIGURE 9B</label><graphic xlink:href="taos00005-0789-b" xlink:role="774"></graphic></fig><fig id="F26"><label>FIGURE 10A</label><graphic xlink:href="taos00005-0790-a" xlink:role="775"></graphic></fig><fig id="F27"><label>FIGURE 10B</label><graphic xlink:href="taos00005-0790-b" xlink:role="775"></graphic></fig><fig id="F28"><label>FIGURE 11</label><graphic xlink:href="taos00005-0791-a" xlink:role="776"></graphic></fig><fig id="F29"><label>FIGURE 12A</label><graphic xlink:href="taos00005-0792-a" xlink:role="777"></graphic></fig><fig id="F30"><label>FIGURE 12B</label><graphic xlink:href="taos00005-0793-a" xlink:role="778"></graphic></fig><fig id="F31"><label>FIGURE 12C</label><graphic xlink:href="taos00005-0793-b" xlink:role="778"></graphic></fig><fig id="F32"><label>FIGURE 12D</label><graphic xlink:href="taos00005-0794-a" xlink:role="779"></graphic></fig><fig id="F33"><label>FIGURE 13A</label><graphic xlink:href="taos00005-0795-a" xlink:role="780"></graphic></fig><fig id="F34"><label>FIGURE 13B</label><graphic xlink:href="taos00005-0795-b" xlink:role="780"></graphic></fig><fig id="F35"><label>FIGURE 14A</label><graphic xlink:href="taos00005-0796-a" xlink:role="781"></graphic></fig><fig id="F36"><label>FIGURE 14B</label><graphic xlink:href="taos00005-0796-b" xlink:role="781"></graphic></fig><fig id="F37"><label>FIGURE 15A</label><graphic xlink:href="taos00005-0797-a" xlink:role="782"></graphic></fig><fig id="F38"><label>FIGURE 15B</label><graphic xlink:href="taos00005-0799-a" xlink:role="784"></graphic></fig><fig id="F39"><label>FIGURE 15C</label><graphic xlink:href="taos00005-0800-a" xlink:role="785"></graphic></fig><fig id="F40"><label>FIGURE 15D</label><graphic xlink:href="taos00005-0801-a" xlink:role="786"></graphic></fig><fig id="F41"><label>FIGURE 16A</label><graphic xlink:href="taos00005-0802-a" xlink:role="787"></graphic></fig><fig id="F42"><label>FIGURE 16B</label><graphic xlink:href="taos00005-0803-a" xlink:role="788"></graphic></fig><fig id="F43"><label>FIGURE 16C</label><graphic xlink:href="taos00005-0804-a" xlink:role="789"></graphic></fig><fig 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