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Apoptosis in Human Corneas with Keratokonus, after Stromal Keratitis and after Excimer Laser Surgery

Amm M., Seeck N., Nölle B.,
Christian-Albrechts-Universität Kiel, Klinik für Ophthalmologie (Kiel)

Purpose: Programmed cell death, or apoptosis is an essential mechanism in development, homeostasis, wound healing, and pathophysiology of tissues of multicellular organisms. 
Methods: We investigated the presence of apoptotic cell death in corneas of patients with keratokonus (8 corneas), after stromal keratitis (8 corneas) and after phototherapeutic keratectomy (8 corneas) using three different methods. Corneas were processed for light and electron microscopy and in situ end labeling of fragmented DNA (TUNEL-technique). 
Results: We found increased apoptotic cells in keratokonus corresponding to the clinical aspect in all three techniques. After stromal keratitis apoptosis was insignificant. After excimer laser surgery TUNEL-positive cells were accumulated in the epithelium and within upper stromal cell conglomeration. Posterior stroma and endothelium were normal. 
Conclusions: Apoptosis is found in keratokonus and in the proliferative healing response of excimer laser surgery. It may play a pathogenetic role.

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