Prevention of Keratocyte Loss After Corneal Deepithelialization in Rabbits

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Abstract
Purpose: To determine if keratocyte loss, after removal of the corneal epithelium, can be prevented by a collagen shield used alone or in combination with a topically applied corneal preservation medium. Methods: Twenty-four New Zealand white rabbits were divided into six groups of four rabbits each. The central 6 mm of corneal epithelium was removed from one eye of each animal by means of a blunt spatula. Postoperatively, these eyes were treated every 4 hours for 24 hours with the following: group 1, balanced salt solution (BSS) drops (Akorn Inc, Metairie, La); group 2, Optisol drops (Chiron IntraOptics, Irvine, Calif); group 3, a collagen shield soaked in sterile BSS plus BSS drops; group 4, the same collagen shield soaked in Optisol plus Optisol drops; group 5, a different collagen shield soaked in sterile BSS plus BSS drops; and group 6, the same collagen shield soaked in Optisol plus Optisol drops. The animals were killed at 24 hours after surgery, the corneas were fixed, and keratocytes within the anterior and posterior cornea, beneath the epithelial defect, were quantitated. Four untreated rabbits served as controls. Results: Optisol drops alone, applied every 4 hours after deepithelialization, did not prevent keratocyte loss to a greater extent than did BSS drops alone (P=.96). Both collagen shields soaked in sterile BSS plus BSS drops every 4 hours were associated with less keratocyte loss than were BSS or Optisol drops alone. Both collagen shields soaked in Optisol plus Optisol drops every 4 hours were most successful at minimizing keratocyte loss (P=.0002 andP=.001). Conclusion: After corneal deepithelialization, use of a collagen shield in combination with topical application of a corneal storage medium may minimize keratocyte loss and may thus be beneficial after refractive surgery.