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RGTA in corneal wound healing after transepithelial laser ablation in a rabbit model: a randomized, blinded, placebo‐controlled study
Author(s) -
Xeroudaki Maria,
Peebo Beatrice,
Germundsson Johan,
Fagerholm Per,
Lagali Neil
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13116
Subject(s) - wound healing , cornea , medicine , ophthalmology , placebo , pathology , stromal cell , corneal epithelium , epithelium , fluorescein , confocal microscopy , surgery , biology , physics , alternative medicine , quantum mechanics , fluorescence , microbiology and biotechnology
Purpose To evaluate the efficacy of the agent RGTA for epithelial, stromal and nerve regeneration after laser‐induced corneal wounding in rabbits. Methods After excimer laser wounding of the anterior cornea in 25 New Zealand white rabbits, topical RGTA or placebo was applied in a randomized, masked manner. Fluorescein epithelial staining was performed on the first 5 postoperative days. In vivo confocal microscopy of corneal subbasal nerves and stroma was performed preoperatively and on week 2, 4, 8 and 16. At 16 weeks, corneas were stained for beta‐ III tubulin expression. Results Postoperatively, all epithelia had closed by at least 90% after the third postoperative day. No significant difference in epithelial wound size was found between RGTA and placebo‐treated groups, and RGTA did not hinder fluorescein binding. After epithelial wound closure, corneas remained transparent to 16 weeks. By confocal microscopy, subclinical stromal haze was significantly deeper in placebo‐treated eyes (mean depth 60 μm) relative to RGTA group (52 μm), p = 0.02. Regenerating beta‐ III tubulin‐positive subbasal nerves were observed in all corneas, but partial masking by haze rendered quantitative analysis unreliable. Conclusions RGTA restored stromal microarchitecture and reduced subclinical haze relative to placebo. The mild epithelial wound quickly healed regardless of treatment suggesting an optimal natural healing process in freshly wounded healthy corneas, and indicating that RGTA may be more suitable for healing of chronic or more aggressive wounds. Limitations of the rabbit model for nerve quantification in the presence of haze should also be recognized.