97th DOG Annual Meeting 1999
SCREENING OF MYOPIC LASIK PATIENTS WITH AGGRESSIVE WOUNDHEALING: QUANTITATIVE DETERMINATION OF EGF M-RNA IN CORNEAL EPITHELIAL CELLS
C. P. Lohmann, C. Winkler v. Mohrenfels, U. Reischl, A. Muller, J. Güell
Wound healing of the cornea is of critical importance for the refractive outcome of myopic Lasik. Recent studies have indicated that postoperative epithelial hyperplasia ("compensatory epithelial hyperplasia") may be responsible for postoperative regression. For the origin of epithelial hyperplasia epidermal growth factor (EGF) is of importance because EGF is well known for ist potential to enhance epithelial proliferation. The aim of this study was to determine the individual EGF mRNA concentration in the corneal epithelial cells and consequently to detect patients with an aggressive wound healing response.
Patients and Methods: In 21 eyes (17 patients) with a myopia of - 10,0 D a biopsy of the epithelium (0,8 mm in diameter) was made 2,0 mm from the limbus away prior to the Lasik procedure. The EGF mRNA concentration in the epithelial cells was quantitatively measured by PCR and ELISA and the values were correlated with the postoperative refraction at 4 months.
Results: All eyes were around emmetropia 3 weeks after the surgery. At 4 months postoperatively, 14 eyes were within +/- 1,0 D of emmetropia, whereas 7 eyes showed regression between 1,50 and 4,75 D. In eyes with regression higher levels of EGF mRNA was found compared to eyes with postoperative emmetropia (correlationfactor r = -0,965).
Conclusion: The preoperative, individual concentration of EGF mRNA in the corneal epithelial cells might be an indicator for the postoperative outcome of myopic Lasik.
Universitäts-Augenklinik, Franz-Josef-Strauss-Allee, 93042 Regensburg
Insituto de Microcirugia Ocular (IMO) Barcelona, Spanien