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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMEDEIROS, Carla S.
dc.contributor.authorMARINO, Gustavo K.
dc.contributor.authorLASSANCE, Luciana
dc.contributor.authorSHANMUGAPRIYA, Thangavadivel
dc.contributor.authorSANTHIAGO, Marcony R.
dc.contributor.authorWILSON, Steven E.
dc.identifier.citationJOURNAL OF REFRACTIVE SURGERY, v.34, n.12, p.790-798, 2018
dc.description.abstractPURPOSE: To determine how photorefractive keratectomy (PRK) and mitomycin C (MMC) affect corneal nerves and their regeneration over time after surgery. METHODS: Twenty-eight New Zealand rabbits had corneal epithelial scraping with (n = 3) and without (n = 3) MMC 0.02% or -9.00 diopter PRK with (n = 6) and without (n = 16) MMC 0.02%. Corneas were removed after death and corneal nerve morphology was evaluated using acetylcholinesterase immunohistochemistry and beta-III tubulin staining after 1 day for all groups, after 1 month for PRK with and without MMC, and 2, 3, and 6 months after PRK without MMC. Image-Pro software (Media Cybernetics, Rockville, MD) was used to quantitate the area of nerve loss after the procedures and, consequently, regeneration of the nerves over time. Opposite eyes were used as controls. RESULTS: Epithelial scraping with MMC treatment did not show a statistically significant difference in nerve loss compared to epithelial scraping without MMC (P = .40). PRK with MMC was significantly different from PRK without MMC at 1 day after surgery (P = .0009) but not different at 1 month after surgery (P = .90). In the PRK without MMC group, nerves regenerated at 2 months (P < .0001) but did not return to the normal preoperative level of innervation until 3 months after surgery (P = .05). However, the morphology of the regenerating nerves was abnormal-with more tortuosity and aberrant innervation compared to the preoperative controls-even at 6 months after surgery. CONCLUSIONS: PRK negatively impacts the corneal nerves, but they are partially regenerated by 3 months after surgery in rabbits. Nerve loss after PRK extended peripherally to the excimer laser ablated zone, indicating that there was retrograde degeneration of nerves after PRK. MMC had a small additive toxic effect on the corneal nerves when combined with PRK that was only significant prior to 1 month after surgery.eng
dc.description.sponsorshipU.S. Public Health Service from the National Eye Institute, National Institutes of Health, Bethesda, MD [RO1EY10056, P30-EY025585]
dc.description.sponsorshipResearch to Prevent Blindness, Inc., New York, NY
dc.description.sponsorshipNEI [T32 EY007157]
dc.description.sponsorshipCAPES training grant PDSE2016 Brasilia, Brazil
dc.description.sponsorshipOffice of the Director, National Institutes of Health [1S10OD019972-01]
dc.publisherSLACK INCeng
dc.relation.ispartofJournal of Refractive Surgery
dc.subject.othervivo confocal microscopyeng
dc.subject.otherretrograde degenerationeng
dc.titleThe Impact of Photorefractive Keratectomy and Mitomycin C on Corneal Nerves and Their Regenerationeng
dc.rights.holderCopyright SLACK INCeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Luciana:Cleveland Clin, Cole Eye Inst, I-32,9500 Euclid Ave, Cleveland, OH 44195 USA, Thangavadivel:Cleveland Clin, Cole Eye Inst, I-32,9500 Euclid Ave, Cleveland, OH 44195 USA, Steven E.:Cleveland Clin, Cole Eye Inst, I-32,9500 Euclid Ave, Cleveland, OH 44195 USA
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