title: Early corneal wound healing and inflammatory responses after refractive lenticule extraction (ReLEx).
abstract: OBJECTIVE
  To compare the early corneal wound repair and inflammatory responses after refractive lenticule extraction (ReLEx) and LASIK.
  
  
  METHODS
  Eighteen rabbits underwent ReLEx and another 18 underwent LASIK. Each group was divided into three subgroups of six rabbits each and these were subjected to refractive corrections of -3.00 diopters (D), -6.00 D, and -9.00 D. Slit lamp photography, anterior segment optical coherence tomography (AS-OCT), corneal topography, and in vivo confocal microscopy were performed 1 day after surgery. After euthanatization, the corneas were subjected to immunofluorescent staining for fibronectin, CD11b, Ki-67, and TUNEL assay.
  
  
  RESULTS
  On slit lamp microscopy, all corneas appeared clear pre- and postoperatively in both ReLEx and LASIK eyes. Corneal topography showed a more significant corneal flattening after LASIK than after ReLEx as the degree of correction was increased (P = 0.916 after -3.00 D correction to P = 0.097 after -9.00 D correction). In vivo confocal microscopy showed less light-scattering particles at the flap interface after ReLEx compared with LASIK. Immunostaining of fibronectin showed a less abundant expression in corneas that underwent ReLEx than LASIK. The differences became more marked as the power of correction was increased. Similar trend was seen in the number of CD11b-positive cells (P = 0.476 after -3.00 D correction to P < 0.001 after -9.00D correction). There was no marked disparity observed in cell death and proliferation between post-ReLEx and -LASIK eyes.
  
  
  CONCLUSIONS
  This study has shown that the ReLEx procedure may result in less topographic changes, inflammation, and early extracellular matrix deposition than LASIK, especially at high refractive correction.
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: Andri K
authors.initials: AK
authors.lastname: Riau
authors.forename: Romesh I
authors.initials: RI
authors.lastname: Angunawela
authors.forename: Shyam S
authors.initials: SS
authors.lastname: Chaurasia
authors.forename: Wing S
authors.initials: WS
authors.lastname: Lee
authors.forename: Donald T
authors.initials: DT
authors.lastname: Tan
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000818:Animals; D039481:CD11b Antigen / Q000378:metabolism; D016923:Cell Death; D049109:Cell Proliferation; D003315:Cornea / Q000378:metabolism*; D003319:Corneal Stroma / Q000601:surgery; D048988:Corneal Surgery, Laser / Q000379:methods*; D019781:Corneal Topography; D005353:Fibronectins / Q000378:metabolism; D019084:Fluorescent Antibody Technique, Indirect; D020287:In Situ Nick-End Labeling; D007634:Keratitis / Q000378:metabolism*; D019394:Ki-67 Antigen / Q000378:metabolism; D054018:Lasers, Excimer; D053844:Lasers, Solid-State; D018613:Microscopy, Confocal; D008856:Microscopy, Fluorescence; D011817:Rabbits; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence; D014945:Wound Healing / Q000502:physiology*
chemical_list: D039481:CD11b Antigen; D005353:Fibronectins; D019394:Ki-67 Antigen