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In vivo and ex vivo evaluation of cell–cell interactions, adhesion and migration in ocular surface of patients undergone excimer laser refractive surgery after topical therapy with different lubricant eyedrops

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Abstract

Purpose

To investigate, in vivo by means of in vivo confocal microscopy (IVCM) and ex vivo by impression cytology, epithelial cellular damage after excimer laser refractive surgery in patients under different topical lubricant therapies.

Methods

Two hundred eyes of 100 patients, undergone bilateral excimer laser refractive surgery for medium myopic error correction [spherical equivalent refraction from −1.75 to −3.50 dioptres (D) with refractive astigmatism under −0.75 D], have been recruited. All patients received, in addition to standard therapy for refractive surgery, high weight hyaluronic acid 0.2% eyedrops in one randomly selected eye and carboxymethylcellulose 1% eyedrop in the comparator eye (control eye) 4 times daily for 90 days. Follow-up included a baseline visit and further examination 7-, 30- and 90-day intervals [clinical evaluation with Schirmer test and tear break-up time (TBUT), IVCM and impression cytology].

Results

No significant difference in Schirmer test and TBUT was observed during the follow-up period in eyes under different therapies. IVCM showed an improvement of conjunctival and corneal epithelial cells quality in eye in treatment with high weight hyaluronic acid 0.2% when compared to carboxymethylcellulose. Conjunctival impression cytology demonstrated an evident positivity for CD44 in eyes treated with both treatments in all follow-up controls. ICAM1 expression showed an increasing positivity starting at 30 days that became statistically significant after 90 days of high weight hyaluronic acid 0.2% therapy (p = 0.0167).

Conclusions

In vivo and in vitro results showed the effectiveness of high weight hyaluronic acid 0.2% in facilitating cell–cell interaction, migration, cell proliferation, stabilizing epithelial barrier of the ocular surface. Moreover, use of high weight hyaluronic acid in treatment of corneal tissue damage after refractive surgery, in concordance with standard topical corticosteroids and antibiotics therapy, could be effective in promoting corneal epithelial wound healing with consequent good results in clinical outcome and patients’ satisfaction.

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Authors and Affiliations

  1. Department of Medicine and Ageing Sciences, Ophthalmology Clinic, University“G. d’Annunzio” of Chieti–Pescara, Chieti, Italy

    Roberta Calienno, Manuela Lanzini, Mario Nubile & Leonardo Mastropasqua

  2. Department of Medicine and Ageing Sciences, Visual Science Laboratory, CeSI, University“G. d’Annunzio” of Chieti–Pescara, Via dei Vestini, 66100, Chieti, Italy

    Claudia Curcio

Authors
  1. Roberta Calienno
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  2. Claudia Curcio
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  3. Manuela Lanzini
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  4. Mario Nubile
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  5. Leonardo Mastropasqua
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Correspondence to Claudia Curcio.

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Conflict of interest

The authors declare that they have non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Calienno, R., Curcio, C., Lanzini, M. et al. In vivo and ex vivo evaluation of cell–cell interactions, adhesion and migration in ocular surface of patients undergone excimer laser refractive surgery after topical therapy with different lubricant eyedrops. Int Ophthalmol 38, 1591–1599 (2018). https://doi.org/10.1007/s10792-017-0627-y

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  • DOI: https://doi.org/10.1007/s10792-017-0627-y

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