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Cornea. 2018 Apr;37(4):501-507. doi: 10.1097/ICO.0000000000001430.

Hypoxia and the Prolyl Hydroxylase Inhibitor FG-4592 Protect Corneal Endothelial Cells From Mechanical and Perioperative Surgical Stress.

Author information

1
Cornea Research Foundation of America, Indianapolis, IN.
2
Price Vision Group, Indianapolis, IN.
3
Pristine Eye Clinic, Mumbai, India.
4
School of Optometry, Indiana University, Bloomington, IN.
5
VisionFirst, Indianapolis, IN.

Abstract

PURPOSE:

To determine whether hypoxia preconditioning can protect corneal endothelial cells from mechanical stress and perioperative procedures mimicking Descemet stripping automated endothelial keratoplasty (DSAEK).

METHODS:

Preconditioning was delivered by 2 hours of 0.5% oxygen incubation in a hypoxia chamber or by exposure to the prolyl hydroxylase inhibitor FG-4592, which prevents hypoxia-inducible factor-1 alpha degradation. Damage to whole corneas was produced by brief sonication. To mimic use with DSAEK, FG-4592-preconditioned and control donor corneas were dissected with a microkeratome, and the posterior donor button was pulled through a transplant insertion device (Busin glide). The area of endothelial damage was determined by trypan blue staining.

RESULTS:

In all cases, hypoxia preconditioning or incubation with FG-4592 protected corneal endothelial cells from death by mechanical stress. Hypoxia-preconditioned human and rabbit corneas showed 19% and 29% less cell loss, respectively, relative to controls, which were both significant at P < 0.05. FG-4592 preconditioning reduced endothelial cell loss associated with preparation and insertion of DSAEK grafts by 23% relative to the control (P < 0.01).

CONCLUSIONS:

These results support the hypothesis that preconditioning by hypoxia or exposure to FG-4592 improves corneal endothelial cell survival and may also provide protection during surgical trauma.

PMID:
29504956
PMCID:
PMC5841548
[Available on 2019-04-01]
DOI:
10.1097/ICO.0000000000001430
[Indexed for MEDLINE]

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