SUTO Chikako    Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine    Position   Professor
Article types	Original article
Language	English
Peer review	Non peer reviewed
Title	Femtosecond laser and microkeratome corneal flaps: comparison of stromal wound healing and inflammation.
Journal	Formal name：Journal of refractive surgery (Thorofare, N.J. : 1995) Abbreviation：J Refract Surg ISSN code：1081597X/1081597X
Volume, Issue, Page	23(7),pp.667-676
Author and coauthor	Netto Marcelo V†, Mohan Rajiv R, Medeiros Fabricio W, Dupps William J, Sinha Sunilima, Krueger Ronald R, Stapleton W Michael, Rayborn Mary, Suto Chikako, Wilson Steven E
Publication date	2007/09
Summary	PURPOSE:To examine early postoperative wound healing in rabbit corneas that had LASIK flaps formed with three different models (15 KHz, 30 KhZ, and 60 KHz) of a femtosecond laser compared with flaps formed with a microkeratome.METHODS:Thirty-nine rabbit eyes were randomized to receive either no surgery or corneal flaps formed with one of the lasers or the microkeratome. Sixteen eyes also had lamellar cuts with no side cuts with the 30 KHz laser. Animals were sacrificed and corneas processed as frozen sections or fixed for transmission electron microscopy. Frozen sections were evaluated with the TUNEL assay to detect apoptosis, immunocytochemistry for Ki67 to detect cell mitosis, and immunocytochemistry for CD11b to detect mononuclear cells.RESULTS:Rabbit corneas that had flaps formed with the 15 KHz laser had significantly more stromal cell death, greater stromal cell proliferation, and greater monocyte influx in the central and peripheral comea at 24 hours after surgery than corneas that had flaps formed with the 30 KHz or 60 KHz laser or the microkeratome. Results of the 60 KHz laser and microkeratome were not significantly different for any of the parameters at 24 hours, except for mitotic stromal cells at the flap margin. Transmission electron microscopy revealed that the primary mode of stromal cell death at 24 hours after laser ablation was necrosis.CONCLUSIONS:Stromal cell necrosis associated with femtosecond laser flap formation likely contributes to greater inflammation after LASIK performed with the femtosecond laser, especially with higher energy levels that result in greater keratocyte cell death.
PMID	17912936