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Bevacizumab and rapamycin can decrease corneal opacity and apoptotic keratocyte number following photorefractive

Kyoung Sub Lee1, Dong-Ah Ko, Eun-Soon Kim

  • 1Department of Ophthalmology and Biomedical Institute of Technology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Investigative Ophthalmology & Visual Science
|October 18, 2012
PubMed
Summary

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Bevacizumab and rapamycin reduce corneal haze and cell death after refractive surgery. These drugs may offer safer alternatives to mitomycin C, with less impact on corneal cells.

Area of Science:

  • Ophthalmology
  • Regenerative Medicine
  • Corneal Surgery

Background:

  • Photorefractive keratectomy (PRK) followed by UV-B irradiation can cause central corneal opacity.
  • Keratocyte apoptosis contributes to corneal haze and opacity post-PRK.
  • Mitomycin C (MMC) is used to prevent haze but can affect keratocyte survival.

Purpose of the Study:

  • To evaluate the efficacy of bevacizumab and rapamycin in reducing corneal opacity and keratocyte apoptosis after PRK and UV-B irradiation.
  • To compare the effects of bevacizumab and rapamycin with mitomycin C (MMC) and a control.

Main Methods:

  • Sixty Sprague-Dawley rats underwent PRK (80 μm ablation, 3-mm zone).
  • Groups received intraoperative application of MMC (0.02%), bevacizumab (2.5%), rapamycin (0.01%), or balanced saline solution (control) for 2 minutes.

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  • All eyes were exposed to UV-B irradiation (100 mJ/cm²) at 3 weeks post-PRK.
  • Haze, apoptotic keratocytes, and keratocyte numbers were assessed at 3, 6, and 12 weeks via biomicroscopy, TUNEL staining, and histology.
  • Main Results:

    • Bevacizumab and rapamycin significantly reduced central corneal haze and apoptotic keratocyte numbers compared to the control group at 6 and 12 weeks.
    • At 6 weeks, keratocyte numbers were lower in the MMC group than in the bevacizumab and rapamycin groups.
    • At 12 weeks, keratocyte numbers were significantly lower in the MMC group than in the rapamycin and control groups.

    Conclusions:

    • Intraoperative bevacizumab and rapamycin effectively decrease corneal haze and keratocyte apoptosis following PRK and UV-B irradiation.
    • Bevacizumab and rapamycin demonstrate potential as safer alternatives to MMC in refractive surgery.
    • These agents may prevent postoperative corneal opacity while better preserving keratocyte populations.