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  • Title: Absence of scar formation in human donor cornea with prior laser in situ keratomileusis.
    Author: Priglinger SG, May CA, Alge CS, Wolf A, Neubauer AS, Kampik A, Welge-Luessen U.
    Journal: J Cataract Refract Surg; 2005 Jul; 31(7):1403-8. PubMed ID: 16105614.
    Abstract:
    PURPOSE: To investigate transglutaminases (enzymes capable of cross-linking extracellular matrix proteins to proteolysis-resistant complexes during scar tissue formation) in a human donor cornea after successful laser in situ keratomileusis (LASIK) without clinical complications and to compare with the results in a human donor cornea with corneal scarring after corneal injury. SETTING: Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany. METHODS: A donor cornea with prior uneventful LASIK treatment and 1 with corneal scarring after penetrating injury were investigated. Cryostat sections were stained immunohistochemically for tissue transglutaminase (tTG), keratocyte transglutaminase (kTG), and their reaction product epsilon-(gamma-glutamyl)-lysine. RESULTS: With light microscopy, the flap interface of the LASIK-treated eye could hardly be detected, while in the injured eye, infiltration of cells and a clear margin next to the scar formation were present. Immunohistochemistry demonstrated a distinct staining for tTG, kTG, and epsilon-(gamma-glutamyl)-lysine in the corneal scar. In contrast, neither transglutaminase nor epsilon-(gamma-glutamyl)-lysine staining could be observed at the flap margin or in the interface of the LASIK-treated donor eye. CONCLUSIONS: Irreversible protein cross-linking of transglutaminases via epsilon-(gamma-glutamyl)-lysine connections seem to be indicators for scarring in corneal wound healing. The absence of transglutaminases and their reaction product epsilon-(gamma-glutamyl)-lysine in a LASIK-treated cornea supports the idea of missing scar tissue formation after LASIK surgery.
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