title: In vitro immunohistochemical and morphological observations of penetrating corneal incisions created by a femtosecond laser used for assisted intraocular lens surgery.
abstract: OBJECTIVE
  To compare inflammatory cell response and morphological aspects of femtosecond laser-created corneal incisions.
  
  
  METHODS
  Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  In 16 of 22 human corneoscleral buttons, clear corneal tunnel incisions were created using a femtosecond laser (Lensx) with 7 μJ laser pulse energy on the outer periphery and manually using a phaco knife on the respective opposite side (180 degrees). In 6 corneas, no treatment was performed (controls). Corneas were then kept in organ culture for 12 or 48 hours, and the inflammatory reaction was evaluated using standard immunofluorescence analyses for monocytes (CD11b) and for dendritic cells (HLA-DR). For morphological analyses and apoptosis, van Gieson staining and terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling was performed.
  
  
  RESULTS
  There were no statistically significant differences in inflammatory cell response between femtosecond laser corneal incisions and manually performed incisions. Apoptosis was significantly more pronounced in the femtosecond incisions. The ratio of dendritic cells between femtosecond incisions and manual incisions was 1:2 (12 hours and 48 hours; P=.07), the ratio of monocytes was 1:2 (12 hours and 48 hours; P=.08), and the ratio of apoptotic cells was 1:5 (12 hours) and 1:6 (48 hours) (P=.02). Femtosecond laser incisions showed a more sawtooth-like cutting edge than manual incisions.
  
  
  CONCLUSIONS
  Femtosecond laser-created corneal incisions in human corneas showed no differences in inflammatory cell response but a significantly higher cell death rate than manually performed incisions, indicating an upregulated postoperative wound-healing response.
  
  
  BACKGROUND
  Proprietary or commercial disclosures are listed after the references.
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria.
authors.forename: Wolfgang J
authors.initials: WJ
authors.lastname: Mayer
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria.
authors.forename: Oliver K
authors.initials: OK
authors.lastname: Klaproth
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria.
authors.forename: Fritz H
authors.initials: FH
authors.lastname: Hengerer
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kook
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Dirisamer
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Priglinger
authors.affiliation: From the Departments of Ophthalmology, Goethe-University (Mayer, Klaproth, Hengerer, Kohnen), Frankfurt am Main, and Ludwig-Maximilians-University (Mayer, Kook), Munich, Germany; the Department of Ophthalmology (Dirisamer, Priglinger), Allgemeines Krankenhaus Linz, Austria. Electronic address: kohnen@em.uni-frankfurt.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohnen
mesh_terms: D017209:Apoptosis; D039481:CD11b Antigen / Q000378:metabolism; D003315:Cornea / Q000473:pathology* / Q000601:surgery*; D003713:Dendritic Cells / Q000378:metabolism / Q000473:pathology*; D019084:Fluorescent Antibody Technique, Indirect; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D020287:In Situ Nick-End Labeling; D053685:Laser Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D009000:Monocytes / Q000378:metabolism / Q000473:pathology*; D009924:Organ Culture Techniques; D018918:Phacoemulsification; D014019:Tissue Donors; D014945:Wound Healing
chemical_list: D039481:CD11b Antigen; D006684:HLA-DR Antigens; C509295:ITGAM protein, human