In the last decade PhotoBioModulation therapy (PBM) gained importance in clinical practice, thanks to the technological development of low cost lights sources in a broad wavelength range. In wound management, PBM has been listed as physical therapy and blue light has been used in case of insufficient healing, as in chronic and hard-to-heal wounds. In our previous study in in vivo model, we demonstrated that blue light (410-430 nm) can modulate fibroblasts activity in superficial wounds. Here, we present a study about the effects of blue light (3.43-6.87-13.7-20.6-30.9 and 41.2 J/cm2 doses applied, 410–430 nm, 0.69 W/cm2 power density) on cellular metabolism, proliferation and viability of human fibroblasts obtained from keloid and perilesional tissues, compared with fibroblasts isolated from healthy skin. Excessive healing, where fibrotic tissue is formed, is an aberration in wound healing, denoted by keloids and hypertrophic scars. In the study, electrophysiology was used to investigate the effects on membrane currents while Raman spectroscopy revealed the mitochondrial Cytochrome C oxidase dependence on blue light irradiation. Also, the keratinocytes cell line was tested and co-cultures were prepared to perform scratch test assays. Finally, a simple model to study the effectiveness of light irradiation in cells in the depth tissue, was optimized using a dermal substitute. Overall, these data demonstrate that PBM can be used as an innovative and minimally-invasive approach in wound management not only in case of insufficient healing, but also in skin fibrosis, in association with standard treatments.
Femtosecond laser is routinely used in Ophthalmology to cut donor and patient’s cornea in lamellar or penetrating keratoplasty. Different cut shapes can be chosen, on the basis of the specific patient’s pathology and morphology and on surgeon’s skills. Different cut geometries provide different internal load resistance of the cornea, and this can affect the surgical outcomes. This work aims to qualitatively evaluate the biomechanical load resistance of the different configurations that are currently used in laser assisted keratoplasty, in order to support the surgeon’s choice. A 3D finiteelement biomechanical model of the human cornea was developed and different geometric configurations were designed, taking into account the possible different orientations of the cornea lamellae. We evidenced a different wound resistance to internal loads in the different laser trephined profiles, as well as a different distribution of the stresses in relation to the donor cornea orientation. The analyzed profiles are the mushroom, top hat and anvil. The anvil profile resulted more resistant to the increasing internal pressure, in accordance with the clinical results. The anvil profile enabled the apposition of a restricted number of sutures and early suture removal, thanks to its greater mechanical load resistance. These advantages can contribute to a faster visual recovery in patients undergoing penetrating keratoplasty.
In femtosecond laser assisted keratoplasty different surgical wound profiles can be performed, such as mushroom, zigzag, anvil, Christmas tree, etc. The cut shape is chosen by the surgeon on the basis of patient’s morphology and pathology and on the gained experience. This work aims to qualitatively evaluate the biomechanical load resistance of the different configurations that are currently used in penetrating keratoplasty (PK), in order to support the surgeon’s choice. A 2D and a 3D finite-element biomechanical model of the human cornea was developed and different geometric configurations for PK were designed. The internal pressure was raised until the wound misaligned; wound prolapse then occurred. As a result, we evidenced a different wound resistance to internal loads in the different laser trephined profiles. The anvil profile was more resistant to the increasing internal pressure than was the mushroom or the zig zag pattern. This result is in accordance with the clinical results observed in previously treated patients. The anvil profile enabled the apposition of a restricted number of sutures and early suture removal, thanks to its greater mechanical load resistance. These advantages can contribute to a faster visual recovery in patients undergoing penetrating keratoplasty.
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