Jurnal Penelitian DR Eko

DOI : 10.35124/bca.2019.19.S2.
4889
Biochem. Cell. Arch. Vol. 19, Supplement 2, pp. 4889-4897, 2019 www.connectjournals.com/bca ISSN 0972-5075
INTRACAMERAL INJECTION OF LIMBAL MESENCHYMAL STEM CELLS

CONDITIONED MEDIA (LMSCs-CM) IMPROVE CLINICAL OUTCOME
WITH DELAYED ON Na-K ATPase CORNEAL ENDOTHELIAL PUMP
RECOVERY IN PHACOEMULSIFIED RABBIT EYES
Eko Widayanto1, Nurwasis1, Dicky Hermawan1, Arief Fidianto1, Paramita Putri1, Yuyun Rindiastuti1,
Willy Sandhika2, Igo Syaiful Ihsan3, Hendrian D. Soebagdjo1 and Evelyn Komaratih1
1
Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital,
Surabaya, Indonesia.
2
Department of Pathological Anatomy, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital,
Surabaya, Indonesia.
3
Stem Cell Research and Development Center, Universitas Airlangga, Surabaya, Indonesia.
email:ekowiopthal@gmail.com
(Received 11 August 2019, Revised 20 October 2019, Accepted 25 October 2019)
ABSTRACT : To investigate the effect of LMSCs-CM on central corneal thickness (CCT) and Na+/K+ ATPase of endothelial
cells expression inphacoemulsifiedrabbit eyes. This was a true experimental laboratory study on rabbits using a pre and post-
test control group design. Approximately 24 rabbit eyes were exposed to phacoemulsification ultrasound, then randomly divided
into 2 groups. The control group was injected using 0.2 ml of physiological saline (BSS) intracamerally, while the treatment
group was injected with 0.2 LMSCs-CM intracamerally. Central corneal thickness was evaluated on the 3rd day after treatment,
followed by enucleation to analyzed Na+/K+ ATPase expression using immunohistochemistry.The LMSCs-CM significantly
reduced corneal edema and inflammation resulting in clinical improvement. There was no mean difference of CCT between
groups (p = 0.372, α>0.05). However, CCT was higher in the control group (62.00 ± 27.41) when compared to the treatment
group (50.00 ± 36.45 um). Similarly, the expression of Na + / K + ATPase in both groups was not significantly different (p =
0.973, α>0.05). After 3 days, LMSCs-CM exerted clinical improvements, but had a delay in functional recovery, in regards to
Na+/K+ ATPase expression in the corneal endothelial cells.
Key words : Limbalmesenchymal stem cells (LMSC) conditioned media, Na+/K+ ATPase pump, endothelial cells, corneal thickness.
INTRODUCTION and 6.4% after the same procedure was done by senior
Phacoemulsification is a commonly used cataract residents. The main therapeutic choice for corneal
extraction surgery method with a high success rate. A endothelial damage at present is keratoplasty. However,
study at Cicendo Eye Hospital in 2011 showed that 81% the main problem with this method is the high postoperative
of the patients with high myopia had good vision following cell loss when compared to penetrating keratoplasty.
the surgery. Endothelial damage resulting from this Another problem is the limited corneal donor available
procedure is influenced by various preoperative and globally, meaning that new methods are needed to improve
intraoperative factors. Preoperative factors that affect and increase the density of endothelial cell survival (Olson
corneal endothelial cell loss includes age and cataract et al, 1990; O’Brien et al, 2004; Zavala and Jaime, 2013;
grade (Hayashi et al, 1996; Budiman et al, 2011; Nancy Maggon et al, 2017).
and Joyce, 2012; Zavala and Jaime, 2013; Gupta et al, Corneal clarity is regulated by an active metabolic
2014). Blindness related to corneal abnormalities ranks pump from endothelial cells. This metabolic pump is
as the 4th leading cause of blindness globally, with a controlled by Na+/K+ ATPase, which is located in the
prevalence of 5.1%. Studies conducted by Pirazolli et al basolateral endothelial cell membrane. Stimulation of
found that phacoemulsification results in 16.67% loss of corneal endothelial cells from phase G1 to phase S
endothelial cells that are associated with trauma during becomes an important step in increasing the ability of
surgery. Other studies show an endothelial cell loss of 4- endothelial cell proliferation. Methods to achieve this
15% after phacoemulsification by experienced surgeons includes transformation of viral oncogenes, the addition

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DOI : 10.35124/bca.2019.19.S2.

INTRACAMERAL INJECTION OF LIMBAL MESENCHYMAL STEM CELLS

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