Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0172014
Title: Early wound healing and refractive response of different pocket configurations following presbyopic inlay implantation
Authors: Konstantopoulos A.
Liu Y.-C. 
Teo E.P.W.
Lwin N.C.
Yam G.H.F. 
Mehta J.S. 
Keywords: fibronectin
heat shock protein 47
fibronectin
heat shock protein 47
animal experiment
animal model
animal tissue
Article
astigmatism
confocal microscopy
controlled study
cornea cell
cornea thickness
eye surgery
immunohistochemistry
implantation
in vivo study
inlay implantation
keratometry
limit of quantitation
nonhuman
ophthalmological prosthesis
optical coherence tomography
preoperative period
presbyopia
wound healing
animal
astigmatism
biomechanics
cornea
cornea stroma
inflammation
keratometry
Leporidae
metabolism
physiology
presbyopia
refractometry
surgical flaps
wound healing
Animals
Astigmatism
Biomechanical Phenomena
Cornea
Corneal Stroma
Corneal Topography
Fibronectins
HSP47 Heat-Shock Proteins
Immunohistochemistry
Inflammation
Microscopy, Confocal
Preoperative Period
Presbyopia
Rabbits
Refractometry
Surgical Flaps
Wound Healing
Issue Date: 2017
Citation: Konstantopoulos A., Liu Y.-C., Teo E.P.W., Lwin N.C., Yam G.H.F., Mehta J.S. (2017). Early wound healing and refractive response of different pocket configurations following presbyopic inlay implantation. PLoS ONE 12 (2) : e0172014. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0172014
Rights: Attribution 4.0 International
Abstract: Background Presbyopic inlays have mostly been implanted under a corneal flap. Implantation in a pocket has advantages including less postoperative dry eye and neurotrophic effect, and better biomechanical corneal stability. This study investigated the effect of different pocket and flocket dimensions on corneal stability and refractive power after Raindrop™ implantation, and the associated wound healing response. Methodology Ten New Zealand White rabbits had bilateral pocket Raindrop™ implantation. Eyes were allocated to 4 groups: pockets with 4mm, 6mm, and 8mm diameters, and 8mm flocket. They were examined pre-operatively, at day 1, weeks 1, 2, 3 and 4 post-surgery with anterior segment optical coherence tomography, corneal topography and in-vivo confocal microscopy. After euthanasia (week 4), CD11b, heat shock protein (HSP) 47 and fibronectin corneal immunohistochemistry was performed. Results Corneal thickness (mean±SD) increased from 360.0±16.2?m pre-operatively to 383.9±32.5, 409.4±79.3, 393.6±35.2, 396.4±50.7 and 405±20.3?m on day 1, weeks 1,2,3 and 4 respectively (p<0.008, all time-points). Corneal refractive power increased by 11.1±5.5, 7.5±2.5, 7.5±3.1, 7.0±3.6 and 6.3±2.9D (p<0.001). Corneal astigmatism increased from 1.1±0.3D to 2.3±1.6, 1.7±0.7, 1.8±1.0, 1.6±0.9 and 1.6±0.9D respectively (p = 0.033). CT, refractive power change and astigmatism were not different between groups. The 8mm pocket and 8mm flocket groups had the least stromal keratocyte reflectivity. CD11b, fibronectin or HSP47 weren't detected. Conclusions Anatomical and refractive stability was achieved by 1 week; the outcomes were not affected by pocket or flocket configuration. No scarring or inflammation was identified. The 8mm pocket and flocket showed the least keratocyte activation, suggesting they might be the preferred configuration. © 2017 Konstantopoulos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/161528
ISSN: 19326203
DOI: 10.1371/journal.pone.0172014
Rights: Attribution 4.0 International
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