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- W2102288329 abstract "Early flap dislocation with perioperative brimonidine use in laser in situ keratomileusis In their article about flap dislocation, Munoz et al. state that topical brimonidine prevents the formation of subconjunctival hemorrhages after femtosecond laser in situ keratomileusis (LASIK) but significantly increases the risk for early flap dislocation. I offer some plausible explanations for the observed flap dislocation. Immediately after LASIK, the flap is stabilized by the negative (suction) pressure of the corneal endothelial pump only; thus, dryness and adhesion of the flap to the upper tarsal conjunctiva is sufficient to cause slippage of the flap. Several hours later, however, the reepithelialization of the gutter begins to increase flap stability. Therefore, LASIK requires intact epithelium and healthy endothelium early in the postoperative period to sear the flap. The G-protein-coupled receptor/cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) pathway is one of the most common and versatile signal pathways in eukaryotic cells. Stimulation and inhibition of the corneal cAMP/PKA pathway may play a role in important corneal functions such as wound healing and homeostasis. Accordingly, cAMP potentiates the stimulation of corneal epithelial migration by epidermal growth factor in vitro, suggesting that endogenous cAMP might function as a modulator of epithelial wound healing promoted by this growth factor in vivo. It has also been demonstrated that topical application of agents known to increase cAMP increase tear secretion. Given that stimulation of corneal a(2A)-adrenoceptors with brimonidine results in a dose-dependent decrease in cAMP concentration, topical application of this agent may interfere with" @default.
- W2102288329 created "2016-06-24" @default.
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- W2102288329 date "2010-02-01" @default.
- W2102288329 modified "2023-09-25" @default.
- W2102288329 title "Early flap dislocation with perioperative brimonidine use in laser in situ keratomileusis" @default.
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- W2102288329 doi "https://doi.org/10.1016/j.jcrs.2009.09.017" @default.
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