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Extracellular matrix changes in human corneas after radial keratotomy
A V Ljubimov1, S A Alba, R E Burgeson
1Burns & Allen Research Institute, UCLA School of Medicine, Los Angeles, CA, USA.
Experimental Eye Research
|October 21, 1998
Summary
Radial keratotomy causes lasting changes in corneal extracellular matrix and basement membranes, particularly around surgical scars and epithelial plugs, indicating incomplete healing even years post-surgery.
Area of Science:
- Ophthalmology
- Biochemistry
- Tissue Engineering
Background:
- Radial keratotomy (RK) is a refractive surgical procedure.
- Understanding post-RK corneal tissue remodeling is crucial for patient outcomes.
Purpose of the Study:
- To investigate alterations in extracellular matrix (ECM) and basement membrane (BM) components in corneas following radial keratotomy.
- To assess the long-term healing status of RK scars.
Main Methods:
- Immunofluorescence staining of 28 ECM and BM components on human RK autopsy corneas (6 months and 3 years post-surgery) and normal corneas.
- Comparison of component distribution in scarred versus non-scarred corneal regions.
Main Results:
- Accumulation of type III collagen around RK scars.
- Abnormal basement membrane composition around epithelial plugs, with altered type IV collagen isoforms (alpha1-alpha2 chains present, alpha3-alpha4 chains reduced).
- Upregulation of tenascin-C, fibrillin-1, types VIII and XIV collagen in the stroma around scars; tenascin-C persisted in scars at 3 years.
Conclusions:
- Radial keratotomy leads to persistent alterations in corneal ECM and BM composition, particularly around scars and epithelial plugs.
- The observed basement membrane pattern around epithelial plugs resembles limbal BM, not central corneal BM.
- Incomplete scar healing is evident years after RK, characterized by abnormal ECM deposition and altered BM patterns.