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Excimer laser-aided treatment of Fuchs' endothelial dystrophy without corneal graft

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First Author: M.Dirisamer GERMANY

Co Author(s):    S. Kassumeh   S. Priglinger   G. Moloney   N. Luft   R. Fuchshofer   A. Ohlmann     

Abstract Details

Purpose:

State-of-the-art treatment of fuchs corneal endothelial dystrophy (FCED) is the endothelial keratoplasty leading to a high demand of corneal grafts worldwide. This study investigated the excimer-aided ablation of guttae and corneal endothelium as well as a subsequent corneal endothelial regeneration in human corneas ex vivo.

Setting:

Department of Ophthalmology, Ludwig Maximilians-University Munich; Germany

Methods:

Guttae of descemet membranes of FCED patients and corneal endothelium of normal human corneas were ablated using an excimer laser licensed for glaucoma surgery. Specimen were kept in cell culture medium supplemented with 10 µM of rho-kinase inhibitor Ripasudil. Corneal endothelial cell regeneration was observed using light and electron scanning microscopy. Furthermore, the whole corneal samples were evaluated by hematoxylin/eosin staining and immunohistochemical analysis using antibodies against Na+/K+-ATPase.

Results:

Guttae and corneal epithelium could be ablated with an excimer laser without microscopical impact on the basement layer of the descemet membrane or stroma. Complete regeneration of corneal endothelium was accomplished after 26 – 38 days. Light and electron scanning microscopy suggested the establishment of a layer of flat endothelial cells, in line with the hematoxylin/eosin staining. Additionally, Na+/K+-ATPase expression could only be observed on the inner side of the descemet membrane.

Conclusions:

Following ablation of guttae and corneal endothelium with an excimer laser, corneal endothelial cells migrated on the previously ablated surface, supporting the procedures development as a novel graftless treatment option in FCED.

Financial Disclosure:

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