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Liu Q, Celis-Morales C, Sattar N, Welsh P. Association of glycaemic control with intraocular pressure in a large general population: Results from the UK Biobank. Diabetes Obes Metab 2024. [PMID: 39157858 DOI: 10.1111/dom.15865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/18/2024] [Accepted: 07/25/2024] [Indexed: 08/20/2024]
Abstract
AIM To evaluate the association of glycated haemoglobin (HbA1c) and serum glucose with intraocular pressure (IOP) in a large UK general population. MATERIALS AND METHODS Participants were selected from the UK Biobank, excluding those with eye conditions that may affect IOP. IOP was measured using an ocular response analyser. Goldmann-correlated IOP (IOPg) and corneal-compensated IOP (IOPcc) were outcomes of interest, and ocular hypertension was defined as left-eye IOPg or IOPcc > 21 mmHg. HbA1c and random (non-fasting) serum glucose were the exposures of interest. Multivariate restricted cubic spline models, as well as linear regression, were applied to explore the associations of interest. RESULTS Among 68 806 participants (46.5% male), the mean age was 56.7 years. The mean (standard deviation) for IOPg was 15.7 (3.6) mmHg and 15.9 (3.6) mmHg for IOPcc. Occular hypertension was prevalent in 8055 participants (11.7%) and 4178 participants (6.1%) had diabetes. Those with diabetes had higher IOP and a higher prevalence of ocular hypertension. After adjustment for demographic and clinical variables, HbA1c was positively associated with IOP in participants with diabetes, but not in those without diabetes. For every 10-mmol/mol increase in HbA1c, IOPg increased by 0.20 mmHg (95% confidence interval [CI] 0.12, 0.28) and IOPcc by 0.15 mmHg (95% CI 0.07, 0.23); the odds of ocular hypertension was increased by 6% (95% CI 1.00, 1.13) in participants with diabetes. A borderline positive association between serum glucose and IOP was found only in participants without diabetes. CONCLUSIONS Impaired glycaemic control was associated with elevated IOP and a possible risk of ocular hypertension among participants with diabetes but of normal ocular health.
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Affiliation(s)
- Qiaoling Liu
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Xie ZJ, Yuan BW, Chi MM, Hong J. Focus on seed cells: stem cells in 3D bioprinting of corneal grafts. Front Bioeng Biotechnol 2024; 12:1423864. [PMID: 39050685 PMCID: PMC11267584 DOI: 10.3389/fbioe.2024.1423864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
Corneal opacity is one of the leading causes of severe vision impairment. Corneal transplantation is the dominant therapy for irreversible corneal blindness. However, there is a worldwide shortage of donor grafts and consequently an urgent demand for alternatives. Three-dimensional (3D) bioprinting is an innovative additive manufacturing technology for high-resolution distribution of bioink to construct human tissues. The technology has shown great promise in the field of bone, cartilage and skin tissue construction. 3D bioprinting allows precise structural construction and functional cell printing, which makes it possible to print personalized full-thickness or lamellar corneal layers. Seed cells play an important role in producing corneal biological functions. And stem cells are potential seed cells for corneal tissue construction. In this review, the basic anatomy and physiology of the natural human cornea and the grafts for keratoplasties are introduced. Then, the applications of 3D bioprinting techniques and bioinks for corneal tissue construction and their interaction with seed cells are reviewed, and both the application and promising future of stem cells in corneal tissue engineering is discussed. Finally, the development trends requirements and challenges of using stem cells as seed cells in corneal graft construction are summarized, and future development directions are suggested.
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Affiliation(s)
- Zi-jun Xie
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Bo-wei Yuan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Miao-miao Chi
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Jing Hong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Niazi S, del Barrio JA, Doroodgar F, Sanginabadi A, Alinia C, Hashemian SJ, Hashemi H, Alio JL. Biomechanical changes in keratoconus after customized stromal augmentation. Taiwan J Ophthalmol 2024; 14:59-69. [PMID: 38654988 PMCID: PMC11034678 DOI: 10.4103/tjo.tjo-d-23-00155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/01/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE To verify corneal biomechanical changes, poststromal augmentation using myopic small-incision lenticule extraction's (SMILEs) lenticules in advanced keratoconus (KCN) through Corvis ST (Oculus, Wetzlar, Germany). MATERIALS AND METHODS A clinical trial enrolled 22 advanced KCN patients. We implanted lenticules exceeding 100 μ according to a nomogram and evaluated biomechanical factors through Corvis ST at 3-, 6-, and 24-month postimplantation. We examined parameters during the first applanation (A1), second applanation (A2), highest concavity (HC)/max concavity events, and Vinciguerra screening parameters, as recently established criteria derived from the ideal blend of diverse biomechanical and ocular factors and formulated through the application of logistic regression. Regression analyses explored relationships with age, mean keratometry value, thickness, sphere, cylinder, and best-corrected visual acuity. RESULTS Patients were well matched for age, intraocular pressure, and central corneal thickness (CCT). The mean spherical equivalent decreased from -13.48 ± 2.86 Diopters (D) to -8.59 ± 2.17 D (P < 0.007), and mean keratometry decreased from 54.68 ± 2.77 D to 51.95 ± 2.21 D (P < 0.006). Significant increases were observed in HC time (HCT), Radius-central curvature radius at the HC state-, peak distance (PD) during HC state, CCT, first applanation time, and stiffness parameter (A1T and SP-A1), whereas HC deformation amplitude, maximum deformation amplitude ratio at 2 mm, Corvis Biomechanical Index (CBI), integrated radius (IR), second applanation deformation amplitude (A2DA), first applanation velocity and deflection amplitude (A1V and A1DeflA) significantly decreased postlenticule implantation. Multivariable regression revealed age positively correlated with SP-A1 (P = 0.003) and negatively with HC delta Arc length (P = 0.007). Mean K positively correlated with CCT (P = 0.05) and negatively with CBI (P = 0.032). Best-corrected visual acuity positively correlated with HCT (P = 0.044), and the cylinder positively correlated with PD (P = 0.05) and CCT (P = 0.05) whereas negatively with IR (P = 0.025). CONCLUSIONS Stromal augmentation using myopic SMILE lenticules induces significant corneal biomechanical changes in KCN.
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Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azad Sanginabadi
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Seyed Javad Hashemian
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Jorge L. Alio
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
- Vissum Miranza Alicante, Alicante, Spain
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Feliciano AJ, Grant R, Fernández-Pérez J, Giselbrecht S, Baker MB. Introducing Dynamicity: Engineering Stress Relaxation Into Hydrogels Via Thiol-Ene Modified Alginate for Mechanobiological in vitro Modeling of the Cornea. Macromol Biosci 2024; 24:e2300109. [PMID: 37401723 DOI: 10.1002/mabi.202300109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/11/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
Developing biomaterials for corneal repair and regeneration is crucial for maintaining clear vision. The cornea, a specialized tissue, relies on corneal keratocytes, that respond to their mechanical environment. Altering stiffness affects keratocyte behavior, but static stiffness alone cannot capture the dynamic properties of in vivo tissue. This study proposes that the cornea exhibits time-dependent mechanical properties, similar to other tissues, and aims to replicate these properties in potential therapeutic matrices. First, the cornea's stress relaxation properties are investigated using nanoindentation, revealing 15% relaxation within 10 seconds. Hydrogel dynamicity is then modulated using a specially formulated alginate-PEG and alginate-norbornene mixture. The tuning of the hydrogel's dynamicity is achieved through a photoinitiated norbornene-norbornene dimerization reaction, resulting in relaxation times ranging from 30 seconds to 10 minutes. Human primary corneal keratocytes are cultured on these hydrogels, demonstrating reduced αSMA (alpha smooth muscle actin) expression and increased filopodia formation on slower relaxing hydrogels, resembling their native phenotype. This in vitro model can enable the optimization of stress relaxation for various cell types, including corneal keratocytes, to control tissue formation. Combining stress relaxation optimization with stiffness assessment provides a more accurate tool for studying cell behavior and reduces mechanical mismatch with native tissues in implanted constructs.
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Affiliation(s)
- Antonio J Feliciano
- Department of Complex Tissue Regeneration, MERLN Institute, Maastricht University, Maastricht, Netherlands
| | - Rhiannon Grant
- Department of Instructive Biomaterials Engineering, MERLN Institute, Maastricht University, Maastricht, Netherlands
| | - Julia Fernández-Pérez
- Department of Complex Tissue Regeneration, MERLN Institute, Maastricht University, Maastricht, Netherlands
| | - Stefan Giselbrecht
- Department of Instructive Biomaterials Engineering, MERLN Institute, Maastricht University, Maastricht, Netherlands
| | - Matthew B Baker
- Department of Complex Tissue Regeneration, MERLN Institute, Maastricht University, Maastricht, Netherlands
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Antonov AA, Klinicheva EA, Volzhanin AV, Makarova AS. [Effect of refractive surgery on Maklakov tonometry results]. Vestn Oftalmol 2024; 140:51-59. [PMID: 38739131 DOI: 10.17116/oftalma202414002251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
PURPOSE The study investigates the influence of changes in keratometric parameters after refractive surgery on the results of Maklakov tonometry. MATERIAL AND METHODS The study examined a total of 61 people (121 eyes). The patients were divided into a control group with no history of surgery (16 people, 31 eyes), a LASIK group (13 people, 26 eyes), a femtosecond-assisted LASIK (FS-LASIK) group (16 people, 32 eyes), and a photorefractive keratectomy (PRK) group (16 people, 32 eyes). The patients underwent standard examination, keratometry (Km), Maklakov tonometry with a 10 g weight, and elastotonometry with 5, 7.5, and 15 g weights. RESULTS In the LASIK group, the indentation diameter with 5 and 7.5 g weights correlated with Km in the central and near-paracentral zone (r=0.3-0.5). Tonometry with a 10 g weight did not correlate with anything. Tonometry with a 15 g weight inversely correlated with Km in the paracentral points (4 mm) of the strong meridian (r= -0.5 ... -0.7). In the FS-LASIK group, a significant inverse correlation with Km was observed only for the indentation diameter with a 10 g weight in the paracentral (3-4 mm) zone (r= -0.4 ... -0.5). In the PRK group, weak (r<0.4) correlations were found between Km and the indentation diameter of the 7.5 and 10 g weights for the central zone (1-2 mm). No significant correlations were found for 5 and 15 g weights. In the control group, there were practically no correlations for 5 and 7.5 g weights. The indentation diameter of the 10 g weight evenly correlated with Km at all points (r= -0.38 ... -0.60), the indentation of the 15 g weight correlated mainly with the curvature of the horizontal meridian (r= -0.37 ... -0.49). CONCLUSION Tonometry readings with the 10 g weight are the most dependent on Km in different groups, and the readings with the 5 g weight are the least dependent. LASIK is characterized by the largest scatter of dependencies for weights of different masses, FS-LASIK - by the smallest. Tonometry readings with the 5 g weight correlated with Km only in the LASIK group, and this was the only direct correlation. Considering the inverse nature of most correlations, higher Km may be associated with an overestimation of tonometry results, and lower Km - with its underestimation.
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Affiliation(s)
- A A Antonov
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - E A Klinicheva
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - A V Volzhanin
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - A S Makarova
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
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Vrehen AF, Rutten MGTA, Dankers PYW. Development of a Fully Synthetic Corneal Stromal Construct via Supramolecular Hydrogel Engineering. Adv Healthc Mater 2023; 12:e2301392. [PMID: 37747759 DOI: 10.1002/adhm.202301392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/14/2023] [Indexed: 09/26/2023]
Abstract
Recent advances in the field of ophthalmology show great potential in the design of bioengineered constructs to mimic the corneal stroma. Hydrogels based on synthetic supramolecular polymers, are attractive synthetic mimics of the natural highly hydrated corneal stroma. Here, a fully synthetic corneal stromal construct is developed via engineering of an injectable supramolecular hydrogel based on ureido-pyrimidinone (UPy) moieties. The hydrogel displays a dynamic and tunable behavior, which allows for control of biochemical and mechanical cues. Two hydrogels are developed, a fully synthetic hydrogel functionalized with a bioactive cyclic arginine-glycine-aspartate UPy (UPy-cRGD) additive, and a hybrid hydrogel based on UPy-moieties mixed with collagen type I fibers. Both hydrogels supported cell encapsulation and associated cellular deposition of extracellular matrix (ECM) proteins after 21 days. Excitingly, the hydrogels support the activation of isolated primary keratocytes into stromal fibroblasts as well as the differentiation toward more quiescent corneal stromal keratocytes, demonstrated by their characteristic long dendritic protrusions and a substantially diminished cytokine secretion. Furthermore, cells survive shear stresses during an injectability test. Together, these findings highlight the development of an injectable supramolecular hydrogel as a synthetic corneal stromal microenvironment able to host primary keratocytes.
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Affiliation(s)
- Annika F Vrehen
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Cell and Tissue Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology, Groene Loper 7, Eindhoven, 5612 AZ, The Netherlands
| | - Martin G T A Rutten
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Cell and Tissue Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology, Groene Loper 7, Eindhoven, 5612 AZ, The Netherlands
| | - Patricia Y W Dankers
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Cell and Tissue Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology, Groene Loper 7, Eindhoven, 5612 AZ, The Netherlands
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Gingras AA, Jansen PA, Smith C, Zhang X, Niu Y, Zhao Y, Roberts CJ, Herderick ED, Swindle-Reilly KE. 3D Bioprinting of Acellular Corneal Stromal Scaffolds with a Low Cost Modified 3D Printer: A Feasibility Study. Curr Eye Res 2023; 48:1112-1121. [PMID: 37669915 DOI: 10.1080/02713683.2023.2251172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/21/2023] [Accepted: 08/20/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE Loss of corneal transparency is one of the major causes of visual loss, generating a considerable health and economic burden globally. Corneal transplantation is the leading treatment procedure, where the diseased cornea is replaced by donated corneal tissue. Despite the rise of cornea donations in the past decade, there is still a huge gap between cornea supply and demand worldwide. 3D bioprinting is an emerging technology that can be used to fabricate tissue equivalents that resemble the native tissue, which holds great potential for corneal tissue engineering application. This study evaluates the manufacturability of 3D bioprinted acellular corneal grafts using low-cost equipment and software, not necessarily designed for bioprinting applications. This approach allows access to 3D printed structures where commercial 3D bioprinters are cost prohibitive and not readily accessible to researchers and clinicians. METHODS Two extrusion-based methods were used to 3D print acellular corneal stromal scaffolds with collagen, alginate, and alginate-gelatin composite bioinks from a digital corneal model. Compression testing was used to determine moduli. RESULTS The printed model was visually transparent with tunable mechanical properties. The model had central radius of curvature of 7.4 mm, diameter of 13.2 mm, and central thickness of 0.4 mm. The compressive secant modulus of the material was 23.7 ± 1.7 kPa at 20% strain. 3D printing into a concave mold had reliability advantages over printing into a convex mold. CONCLUSIONS The printed corneal models exhibited visible transparency and a dome shape, demonstrating the potential of this process for the preparation of acellular partial thickness corneal replacements. The modified printing process presented a low-cost option for corneal bioprinting.
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Affiliation(s)
- Amelia A Gingras
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Peter A Jansen
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Caroline Smith
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Xu Zhang
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
| | - Ye Niu
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, USA
| | - Yi Zhao
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Cynthia J Roberts
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Edward D Herderick
- Center for Design and Manufacturing Excellence, The Ohio State University, Columbus, OH, USA
| | - Katelyn E Swindle-Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA
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Macedo-de-Araújo RJ, Seco RM, González-Méijome JM. Prospective assessment of corneal biomechanical properties and intraocular pressure after scleral lens wear: A 12-month follow-up study. Cont Lens Anterior Eye 2023; 46:102067. [PMID: 37863714 DOI: 10.1016/j.clae.2023.102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023]
Abstract
PURPOSE To investigate the long-term influence of scleral lens (SL) wear on corneal biomechanical properties and intraocular pressure (IOP) in irregular and regular corneas. Secondary goal comprised evaluate the fluid reservoir (FR) thickness overtime and correlate it with the changes in corneal biomechanical parameters and IOP. METHODS Seventy (70) eyes with irregular corneas (IC Group) and 21 eyes with regular corneas (RC Group) were fitted with 16.4 mm SL and wore the lenses for 12 months. Corrected IOP (IOPcc), Goldmann equivalent IOP (IOPg) and corneal biomechanical parameters (Corneal Hysteresis (CH) and Corneal Resistance Factor (CRF)) were measured with Ocular Response Analyzer. Slit lamp images were analyzed with ImageJ software to assess FR thickness overtime. Measurements were taken at lens dispensing visit prior lens wear (LDV1) and after 60 min of lens wear (LDV2) and at 1, 6 and 12-month follow-up visits. Measurements were done immediately after lens removal. RESULTS There were no statistically significant differences on IOPcc, IOPg, CRF and CH over the follow-up visits in both groups. Mean IOPcc and IOPg fluctuations overtime were clinically insignificant and below 1 mmHg in both groups. IOPg, CH and CRF were significantly lower on IC Group (p < 0.001), although no statistically significant differences were found between groups for IOPcc. Regarding FR thickness, statistically significant differences were found over the follow-up on both groups, with a mean decrease of 186.29 µm on IC Group and 175.32 µm on RC Group (p < 0.001). Statistically significant moderate to high negative correlations between FR and IOPg, CRF and CH were found only in the RC Group. CONCLUSIONS Long-term SL wear was not associated to changes in corneal biomechanical parameters neither on IOP as measured after lens removal. Besides IOP measurement without SL removal, more studies are needed to investigate the potential relationship with SL fitting characteristics (namely FR thickness).
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Affiliation(s)
- Rute J Macedo-de-Araújo
- Clinical & Experimental Optometry Research Lab (CEORLab), University of Minho, Braga, Portugal; Physics Center of Minho and Porto Universities (CF-UM-UP), Braga, Portugal.
| | - Rita Maria Seco
- Clinical & Experimental Optometry Research Lab (CEORLab), University of Minho, Braga, Portugal; Physics Center of Minho and Porto Universities (CF-UM-UP), Braga, Portugal
| | - José M González-Méijome
- Clinical & Experimental Optometry Research Lab (CEORLab), University of Minho, Braga, Portugal; Physics Center of Minho and Porto Universities (CF-UM-UP), Braga, Portugal
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Liu M, Li N, Chen T, Tian G, Lin Y, Gao H, Shi W. Comparison of Corneal Biomechanics Treated With Femtosecond Laser-Assisted In Situ Keratomileusis and Small-Incision Lenticule Extraction by New Corneal Biomechanical Parameters of Corvis ST II. Cornea 2023; 42:1384-1390. [PMID: 36729642 DOI: 10.1097/ico.0000000000003191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/27/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to compare corneal biomechanics treated with femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) for myopia and astigmatism using the new corneal biomechanical parameters of Corvis ST II. METHODS This was a prospective nonrandomized controlled study. Patients treated with FS-LASIK or SMILE between January 2018 and July 2018 were included. Corvis ST II was performed to measure corneal biomechanical parameters, including deformation amplitude ratio 2.0 mm (DA ratio 2.0 mm), integrated inverse radius (Integr Radius), stiffness parameter at first applanation (SP-A1), and Ambrosio relational thickness through the horizontal meridian (ARTh), preoperatively, 1 month postoperatively, and 6 months postoperatively. Pentacam pachymetry was used to assess the reduction in pachymetry. RESULTS Forty-five eyes underwent FS-LASIK, and 45 eyes underwent SMILE. The new parameters obtained by Corvis ST II between preoperative and postoperative measurements showed significant changes after FS-LASIK or SMILE (all P < 0.001). Postoperative SP-A1 significantly decreased in the 2 groups (108.88 ± 14.47-73.32 ± 13.2 in FS-LASIK and 105.79 ± 17.68-73.91 ± 14.81 in SMILE). Eyes with equal preoperative pachymetry, intraocular pressure, and spherical equivalents showed no significant differences in these new parameters measured using Corvis ST II ( all P > 0.05) between the 2 groups. The prediction of the laser platform overestimated the measured pachymetry reduction in the SMILE group (111.93 ± 15.18 μm vs. 87.16 ± 15.47 μm). CONCLUSIONS New corneal biomechanical parameters measured using Corvis ST II showed no significant differences between FS-LASIK and SMILE in eyes with homogeneous preoperative parameters. The laser software platform may have overestimated the actual corneal reduction in the eyes treated with SMILE.
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Affiliation(s)
- Mingna Liu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Na Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Tong Chen
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Ge Tian
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Yue Lin
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Weiyun Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
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Zhao GP, Zhai HT, Xiang HZ, Wu LM, Chen QO, Chen C, Zhou M. Biomechanical study of cornea response under orthokeratology lens therapy: A finite element analysis. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3691. [PMID: 36799066 DOI: 10.1002/cnm.3691] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Orthokeratology (OK) is becoming a mainstream modality for myopia correction and control, but its underlying mechanism is not yet fully understood. In this study, the biomechanical response of cornea under the OK lens was investigated to further understand the mechanism of OK therapy. Numerical models of the cornea and OK lens with different corneal refractive powers and myopia degrees were established to analyze features and differences of the spatial displacement and stress distribution in different areas of the anterior corneal surface by finite element method. Displacement distributions on the anterior cornea surface with refractive powers of 39.5, 43, 46 D, and myopia degrees of -1.0, -3.0, -6.0 D demonstrate similar deformation trends and nearly rotationally symmetrical attributes of different corneal parameters. Displacement of mid-peripheral cornea was significantly high compared with that of the central and peripheral cornea, peaking at ~2.4 mm off the corneal apex. The stress increased with the increase in myopia degrees and was significantly large for the myopia degrees of -6.0 D at S1; the stress at S2 and S6 was low and stable and did not differ much at S3; the stress at S4 and S5, however, was extremely high. In summary, simulation result of orthokeratology can effectively evaluate the performance of OK lens and it properly associates with the differential map of the corneal topography. The base curve of the OK lens may also play a role in mid-peripheral corneal steepening. The design around the OK lens' alignment curve needs to be optimized.
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Affiliation(s)
- Gai-Ping Zhao
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hai-Tao Zhai
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hua-Zhong Xiang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Li-Ming Wu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Qi-Ou Chen
- MicroPort Vision Power MedTech (Shanghai) Co., Ltd, Shanghai, China
| | - Chi Chen
- MicroPort Vision Power MedTech (Shanghai) Co., Ltd, Shanghai, China
| | - Meng Zhou
- MicroPort Vision Power MedTech (Shanghai) Co., Ltd, Shanghai, China
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11
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Rohde F, Walther M, Baur F, Windbergs M. A Dual‐Function Electrospun Matrix for the Prevention of Herpes Simplex Virus‐1 Infections after Corneal Transplantation. ADVANCED NANOBIOMED RESEARCH 2023. [DOI: 10.1002/anbr.202200098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Felix Rohde
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
| | - Marcel Walther
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
| | - Florentin Baur
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
| | - Maike Windbergs
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
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12
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Balters L, Reichl S. 3D bioprinting of corneal models: A review of the current state and future outlook. J Tissue Eng 2023; 14:20417314231197793. [PMID: 37719307 PMCID: PMC10504850 DOI: 10.1177/20417314231197793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/13/2023] [Indexed: 09/19/2023] Open
Abstract
The cornea is the outermost layer of the eye and serves to protect the eye and enable vision by refracting light. The need for cornea organ donors remains high, and the demand for an artificial alternative continues to grow. 3D bioprinting is a promising new method to create artificial organs and tissues. 3D bioprinting offers the precise spatial arrangement of biomaterials and cells to create 3D constructs. As the cornea is an avascular tissue which makes it more attractive for 3D bioprinting, it could be one of the first tissues to be made fully functional via 3D bioprinting. This review discusses the most common 3D bioprinting technologies and biomaterials used for 3D bioprinting corneal models. Additionally, the current state of 3D bioprinted corneal models, especially specific characteristics such as light transmission, biomechanics, and marker expression, and in vivo studies are discussed. Finally, the current challenges and future prospects are presented.
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Affiliation(s)
- Leon Balters
- Institute of Pharmaceutical Technology and Biopharmaceutics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Stephan Reichl
- Institute of Pharmaceutical Technology and Biopharmaceutics, Technische Universität Braunschweig, Braunschweig, Germany
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13
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Abdi P, Farsiani AR, Fallah Tafti MR, Latifi G, Abdi P. Effect of ocular biometric factors on corneal biomechanical properties. Int Ophthalmol 2022; 43:1877-1888. [DOI: 10.1007/s10792-022-02587-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/12/2022] [Indexed: 11/25/2022]
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14
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Corneal elastic property investigated by terahertz technology. Sci Rep 2022; 12:19229. [PMID: 36357510 PMCID: PMC9649647 DOI: 10.1038/s41598-022-22033-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/07/2022] [Indexed: 11/12/2022] Open
Abstract
Terahertz (THz) spectroscopy technique has been applied in ex vivo biomechanical properties analysis of human corneas. Upon the application of light pressure on the cornea, the photo elastic birefringent effect, anisotropic deformation, thickness changes and hydration levels will contribute to the sudden phase changes of terahertz time domain signal. The shelf lifetime study shows that the phase shift is reduced and cornea loose the biomechanical properties with the increase of hydration level. Mechanical behaviors have been further studied based on the "fresh" cut corneas with the similar hydration levels. THz signal was collected by focusing inside of the cornea to avoid the phase shift due to light stress caused movement of the corneal surface. By this way, the amount of THz signal refractive index variation is correlated to the elastic property of the corneas. The correlation between the THz signal phase shift and refractive index shift due to the corneal strain can be used to derive the elastic Young's modulus. Our results demonstrated the THz spectroscopy, as a non-contact and non-invasive detection method, could be potential for understanding the mechanism of corneal deformation under the action of intraocular pressure in the physiological environment in future.
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15
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ANGPTL7, a therapeutic target for increased intraocular pressure and glaucoma. Commun Biol 2022; 5:1051. [PMID: 36192519 PMCID: PMC9529959 DOI: 10.1038/s42003-022-03932-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/01/2022] [Indexed: 12/03/2022] Open
Abstract
Glaucoma is a leading cause of blindness. Current glaucoma medications work by lowering intraocular pressure (IOP), a risk factor for glaucoma, but most treatments do not directly target the pathological changes leading to increased IOP, which can manifest as medication resistance as disease progresses. To identify physiological modulators of IOP, we performed genome- and exome-wide association analysis in >129,000 individuals with IOP measurements and extended these findings to an analysis of glaucoma risk. We report the identification and functional characterization of rare coding variants (including loss-of-function variants) in ANGPTL7 associated with reduction in IOP and glaucoma protection. We validated the human genetics findings in mice by establishing that Angptl7 knockout mice have lower (~2 mmHg) basal IOP compared to wild-type, with a trend towards lower IOP also in heterozygotes. Conversely, increasing murine Angptl7 levels via injection into mouse eyes increases the IOP. We also show that acute Angptl7 silencing in adult mice lowers the IOP (~2-4 mmHg), reproducing the observations in knockout mice. Collectively, our data suggest that ANGPTL7 is important for IOP homeostasis and is amenable to therapeutic modulation to help maintain a healthy IOP that can prevent onset or slow the progression of glaucoma.
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16
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Changes in Corneal Morphology and Biomechanics in Cases of Small Incision Lenticule Extraction with Prophylactic Accelerated Collagen Cross-Linking. J Ophthalmol 2022; 2022:1640249. [PMID: 35859778 PMCID: PMC9293522 DOI: 10.1155/2022/1640249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To study the corneal morphology and biomechanics in cases of small incision lenticule extraction with prophylactic accelerated collagen cross-linking (SMILE Xtra). Methods This study was a retrospective study. 28 eyes of 14 patients with moderate-high risk of postoperative ectasia according to the Randleman scoring system underwent SMILE Xtra procedure. Outcome data were recorded including uncorrected distance visual acuity (UDVA), manifest refraction spherical equivalent (MRSE), surface regularity index (SRI), surface asymmetry index (SAI), simulated keratometry (SimK), posterior axial curvature (PAC), anterior and posterior corneal elevations (ACE and PCE), central corneal thickness (CCT), corneal resistance factor (CRF), corneal hysteresis (CH), and cornea-compensated intraocular pressure (IOPcc). The follow-up period was 12 months. Results There were 28, 26, 22, 12, and 10 eyes enrolled at postoperative 1st day and 1st, 3rd, 6th, and 12th months, respectively. The UDVA improved from 1.27 ± 0.18 logMAR preoperatively to -0.06 ± 0.04 logMAR postoperatively (P < 0.05). The MRSE improved from -5.05 ± 1.15 D preoperatively to -0.14 ± 0.30 D postoperatively (P < 0.05). SAI, SimK, PAC, PCE, and CCT all changed significantly at 1st month postoperatively (P < 0.05) and stabilized during the remainder of the follow-up (P > 0.05). There was no significant change in SRI or ACE before and after surgery (P > 0.05). CRF, CH, and IOPcc all decreased significantly at 1st month postoperatively (P < 0.05) and remained stable afterwards (P > 0.05). Conclusions The changes in the corneal morphology and biomechanics remained stable after SMILE Xtra, and there was no sign of postoperative ectasia or refractive regression. Combined with the improvement of visual and refractive results, SMILE Xtra may be a promising method for corneal refractive surgeries in patients at risk.
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17
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Alginate-Based Composites for Corneal Regeneration: The Optimization of a Biomaterial to Overcome Its Limits. Gels 2022; 8:gels8070431. [PMID: 35877516 PMCID: PMC9316786 DOI: 10.3390/gels8070431] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022] Open
Abstract
For many years, corneal transplantation has been the first-choice treatment for irreversible damage affecting the anterior part of the eye. However, the low number of cornea donors and cases of graft rejection highlighted the need to replace donor corneas with new biomaterials. Tissue engineering plays a fundamental role in achieving this goal through challenging research into a construct that must reflect all the properties of the cornea that are essential to ensure correct vision. In this review, the anatomy and physiology of the cornea are described to point out the main roles of the corneal layers to be compensated and all the requirements expected from the material to be manufactured. Then, a deep investigation of alginate as a suitable alternative to donor tissue was conducted. Thanks to its adaptability, transparency and low immunogenicity, alginate has emerged as a promising candidate for the realization of bioengineered materials for corneal regeneration. Chemical modifications and the blending of alginate with other functional compounds allow the control of its mechanical, degradation and cell-proliferation features, enabling it to go beyond its limits, improving its functionality in the field of corneal tissue engineering and regenerative medicine.
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18
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Torres J, H Faris I, Callejas A, Reyes-Ortega F, Melchor J, Gonzalez-Andrades M, Rus G. Torsional wave elastography to assess the mechanical properties of the cornea. Sci Rep 2022; 12:8354. [PMID: 35589817 PMCID: PMC9120141 DOI: 10.1038/s41598-022-12151-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 05/05/2022] [Indexed: 12/13/2022] Open
Abstract
Corneal mechanical changes are believed to occur before any visible structural alterations observed during routine clinical evaluation. This study proposed developing an elastography technique based on torsional waves (TWE) adapted to the specificities of the cornea. By measuring the displacements in the propagation plane perpendicular to the axis of the emitter, the effect of guided waves in plate-like media was proven negligible. Ex vivo experiments were carried out on porcine corneal samples considering a group of control and one group of alkali burn treatment (\documentclass[12pt]{minimal}
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\begin{document}$$\hbox {NH}_\text {4}$$\end{document}NH4OH) that modified the mechanical properties. Phase speed was recovered as a function of intraocular pressure (IOP), and a Kelvin-Voigt rheological model was fitted to the dispersion curves to estimate viscoelastic parameters. A comparison with uniaxial tensile testing with thin-walled assumptions was also performed. Both shear elasticity and viscosity correlated positively with IOP, being the elasticity lower and the viscosity higher for the treated group. The viscoelastic parameters ranged from 21.33 to 63.17 kPa, and from 2.82 to 5.30 Pa s, for shear elasticity and viscosity, respectively. As far as the authors know, no other investigations have studied this mechanical plane under low strain ratios, typical of dynamic elastography in corneal tissue. TWE reflected mechanical properties changes after treatment, showing a high potential for clinical diagnosis due to its rapid performance time and paving the way for future in vivo studies.
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Affiliation(s)
- Jorge Torres
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, Spain.,Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
| | - Inas H Faris
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, Spain. .,Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain.
| | - Antonio Callejas
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, Spain.,Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
| | - Felisa Reyes-Ortega
- Department of Ophthalmology, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Juan Melchor
- Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain.,Excellence Research Unit "ModelingNature" (MNat), Universidad de Granada, Granada, Spain.,Department of Statistics and Operations Research, University of Granada, Granada, Spain
| | - Miguel Gonzalez-Andrades
- Department of Ophthalmology, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
| | - Guillermo Rus
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, Spain.,Biomechanics Group (TEC-12), Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain.,Excellence Research Unit "ModelingNature" (MNat), Universidad de Granada, Granada, Spain
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19
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Tafti MF, Aghamollaei H, Moghaddam MM, Jadidi K, Alio JL, Faghihi S. Emerging tissue engineering strategies for the corneal regeneration. J Tissue Eng Regen Med 2022; 16:683-706. [PMID: 35585479 DOI: 10.1002/term.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Cornea as the outermost layer of the eye is at risk of various genetic and environmental diseases that can damage the cornea and impair vision. Corneal transplantation is among the most applicable surgical procedures for repairing the defected tissue. However, the scarcity of healthy tissue donations as well as transplantation failure has remained as the biggest challenges in confront of corneal grafting. Therefore, alternative approaches based on stem-cell transplantation and classic regenerative medicine have been developed for corneal regeneration. In this review, the application and limitation of the recently-used advanced approaches for regeneration of cornea are discussed. Additionally, other emerging powerful techniques such as 5D printing as a new branch of scaffold-based technologies for construction of tissues other than the cornea are highlighted and suggested as alternatives for corneal reconstruction. The introduced novel techniques may have great potential for clinical applications in corneal repair including disease modeling, 3D pattern scheming, and personalized medicine.
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Affiliation(s)
- Mahsa Fallah Tafti
- Stem Cell and Regenerative Medicine Group, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Hossein Aghamollaei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Jorge L Alio
- Department of Research and Development, VISSUM, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.,Department of Pathology and Surgery, Division of Ophthalmology, Faculty of Medicine, Miguel Hernández University, Alicante, Spain
| | - Shahab Faghihi
- Stem Cell and Regenerative Medicine Group, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
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20
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Gao H, Liu M, Li N, Chen T, Qi X, Xie L, Shi W. Femtosecond laser-assisted minimally invasive lamellar keratoplasty for the treatment of advanced keratoconus. Clin Exp Ophthalmol 2022; 50:294-302. [PMID: 35061331 DOI: 10.1111/ceo.14047] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/05/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND To evaluate the initial safety and efficacy of femtosecond laser-assisted minimal invasive lamellar keratoplasty (FL-MILK) for advanced keratoconus. METHODS Twenty-two patients (22 eyes) with advanced keratoconus were included in this prospective study. All the involved eyes underwent FL-MILK. The femtosecond laser was used to create an intrastromal pocket with a 2.3 mm incision in the recipient cornea. Then a stromal button with a diameter of 9.0 mm and a depth of 200 μm was gently inserted into the intrastromal pocket through the 2.3 mm incision and flattened. No sutures were applied. Follow-up was conducted for 24 months. RESULTS Twenty-two patients completed follow-up data for 12 months, 16 patients had 24 months follow-up. No epithelial implantation, infection or allogeneic rejection were observed during the follow-up. Based on baseline values, postoperative 12 months values and postoperative 24 months values, clinical significantly improvement was recorded in corrected distance visual acuity (CDVA) (0.40 ± 0.18 logMAR vs. 0.30 ± 0.12 logMAR and 0.23 ± 0.13 logMAR), the anterior central corneal elevation (29.14 ± 15.33 μm vs. 14.45 ± 13.75μm and 11.38 ± 8.33 μm), and corneal higher-order aberrations (3.536 ± 1.503 vs. 2.761 ± 1.517 and 0.994 ± 0.391). Corneal biomechanical properties in all eyes improved significantly. SP-A1 increased from 48.64 ± 12.87 preoperatively to 87.26 ± 21.01 postoperative 12 months and 88.77 ± 18.26 postoperative 24 months; deformation amplitude (DA) decreased from 1.36 ± 0.15 preoperatively to 1.21 ± 0.12 postoperative 12 months and 1.19 ± 0.19 postoperative 24 months. CONCLUSIONS Initial experience suggests that this minimally invasive transplantation may be a feasible option for advanced keratoconus. A larger cohort and longer follow-up are required to validate our results and establish long-term safety and efficacy of the procedure.
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Affiliation(s)
- Hua Gao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.,School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Mingna Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.,School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Na Li
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Tong Chen
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Xiaolin Qi
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.,School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Lixin Xie
- School of Ophthalmology, Shandong First Medical University, Jinan, China.,Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Weiyun Shi
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.,School of Ophthalmology, Shandong First Medical University, Jinan, China
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21
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Meduri A, Oliverio G, Severo AA, Camellin U, Rechichi M, Aragona P. Double safe suture during cataract surgery on post radial keratotomy patients using clear corneal incisions. Eur J Ophthalmol 2022; 32:1828-1832. [PMID: 35229692 DOI: 10.1177/11206721221083799] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE the aim of this study is to find a safer surgical approach in cataract surgery on eyes previously treated with radial keratotomy using clear corneal incisions. SETTING Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy. DESIGN Prospective study. METHODS A prospective study was conducted on a group of 20 patients, 21 eyes with 16 RK incisions were evaluated for cataract phacoemulsification. Samples were divided into two groups: Group 1 underwent surgery with pre-operative one corneal stitch along radial keratotomy incisions near the main access site whereas Group 2 underwent modified surgery with two corneal stitches. RESULTS After surgery, visual acuity, corneal hysteresis and corneal strength was evaluated. In all cases, an increased visual acuity was observed. Group 1 showed an UCVA of logMAR 0.22 ± 0.14, while group 2 presented a logMAR of 0.1 ± 0.07. Data did not show a statistically significant difference in UCVA after surgery between the two groups (P = 0.133). Instead, a significant difference in corneal hysteresis (CH), respectively with values of 8.65 ± 1.6 mmHg in group 1 and 9.2 ± 1.8 in group 2 (P = 0.031), and a corneal resistance factor (CRF) with values of 7.87 ± 1.4 mmHg in the first group and 8.65 ± 1.6 mmHg in the second one (P = 0.039) was observed. CONCLUSIONS Double safe suture technique offers better stabilization of corneal structure during surgery in patients preventively treated with 16 incisions RK.
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Affiliation(s)
- Alessandro Meduri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | - Giovanni Oliverio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | - Alice Antonella Severo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | - Umberto Camellin
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | | | - Pasquale Aragona
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Regional Referral Center for the Ocular Surface Diseases, 18980University of Messina, Messina, Italy
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22
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Brar S, Ganesh S, Sriganesh SS, Dorennavar L. Long-term Outcomes of Bowman's Membrane Relaxation for Enhancement of Femtosecond Intrastromal Lenticule Implantation Performed for the Management of High Hyperopia. J Refract Surg 2022; 38:134-141. [DOI: 10.3928/1081597x-20211215-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Becerril-Rodriguez IC, Claeyssens F. Low methacrylated poly (glycerol sebacate) for soft tissue engineering. Polym Chem 2022. [DOI: 10.1039/d2py00212d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Tissue engineering for soft tissue has made great advances in recent years, though there are still challenges to overcome. The main problem is that autologous tissue implants have not given...
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24
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Jameson JF, Pacheco MO, Nguyen HH, Phelps EA, Stoppel WL. Recent Advances in Natural Materials for Corneal Tissue Engineering. Bioengineering (Basel) 2021; 8:161. [PMID: 34821727 PMCID: PMC8615221 DOI: 10.3390/bioengineering8110161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/12/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
Given the incidence of corneal dysfunctions and diseases worldwide and the limited availability of healthy, human donors, investigators are working to generate engineered cellular and acellular therapeutic approaches as alternatives to corneal transplants from human cadavers. These engineered strategies aim to address existing complications with human corneal transplants, including graft rejection, infection, and complications resulting from surgical methodologies. The main goals of these research endeavors are to (1) determine ideal mechanical properties, (2) devise methodologies to improve the efficacy of engineered corneal grafts and cell-based therapies, and (3) optimize transplantation of engineered tissue structures in the eye. Thus, recent innovations have sought to address these challenges through both in vitro and in vivo studies. This review covers recent work aimed at evaluating engineered materials, potential therapeutic cells, and the resulting cell-material interactions that lead to optimal corneal graft properties. Furthermore, we discuss promising strategies in corneal tissue engineering techniques and in vivo studies in animal models.
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Affiliation(s)
- Julie F. Jameson
- Department of Chemical Engineering, University of Florida, Gainesville, FL 32611, USA; (J.F.J.); (M.O.P.)
| | - Marisa O. Pacheco
- Department of Chemical Engineering, University of Florida, Gainesville, FL 32611, USA; (J.F.J.); (M.O.P.)
| | - Henry H. Nguyen
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL 32611, USA;
| | - Edward A. Phelps
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA;
| | - Whitney L. Stoppel
- Department of Chemical Engineering, University of Florida, Gainesville, FL 32611, USA; (J.F.J.); (M.O.P.)
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25
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Preparation and In Vitro Characterization of Gelatin Methacrylate for Corneal Tissue Engineering. Tissue Eng Regen Med 2021; 19:59-72. [PMID: 34665455 DOI: 10.1007/s13770-021-00393-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Corneal disease is second only to cataract considered as the leading cause of blindness in the world, with high morbidity. Construction of corneal substitutes in vitro by tissue engineering technology to achieve corneal regeneration has become a research hotspot in recent years. We conducted in-depth research on the biocompatibility, physicochemical and mechanical properties of rat bone marrow mesenchymal stem cells (rBM-MSCs)-seeded gelatin methacrylate (GelMA) as a bioengineered cornea. METHODS Four kinds of GelMA with different concentrations (7, 10, 15 and 30%) were prepared, and their physic-chemical, optical properties, and biocompatibility with rBM-MSCs were characterized. MTT, live/dead staining, cell morphology, immunofluorescence staining and gene expression of keratocyte markers were performed. RESULTS 7%GelMA hydrogel had higher equilibrium water content and porosity, better optical properties and hydrophilicity. In addition, it is more beneficial to the growth and proliferation of rBM-MSCs. However, the 30%GelMA hydrogel had the best mechanical properties, and could be more conducive to promote the differentiation of rBM-MSCs into keratocyte-like cells. CONCLUSION As a natural biological scaffold, GelMA hydrogel has good biocompatibility. And it has the ability to promote the differentiation of rBM-MSCs into keratocyte-like cells, which laid a theoretical and experimental foundation for further tissue-engineered corneal stromal transplantation, and provided a new idea for the source of seeded cells in corneal tissue engineering.
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26
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Formisano N, Putten C, Grant R, Sahin G, Truckenmüller RK, Bouten CVC, Kurniawan NA, Giselbrecht S. Mechanical Properties of Bioengineered Corneal Stroma. Adv Healthc Mater 2021; 10:e2100972. [PMID: 34369098 DOI: 10.1002/adhm.202100972] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/15/2021] [Indexed: 12/26/2022]
Abstract
For the majority of patients with severe corneal injury or disease, corneal transplantation is the only suitable treatment option. Unfortunately, the demand for donor corneas greatly exceeds the availability. To overcome shortage issues, a myriad of bioengineered constructs have been developed as mimetics of the corneal stroma over the last few decades. Despite the sheer number of bioengineered stromas developed , these implants fail clinical trials exhibiting poor tissue integration and adverse effects in vivo. Such shortcomings can partially be ascribed to poor biomechanical performance. In this review, existing approaches for bioengineering corneal stromal constructs and their mechanical properties are described. The information collected in this review can be used to critically analyze the biomechanical properties of future stromal constructs, which are often overlooked, but can determine the failure or success of corresponding implants.
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Affiliation(s)
- Nello Formisano
- Department of Instructive Biomaterials Engineering MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Cas Putten
- Department of Biomedical Engineering Eindhoven University of Technology Eindhoven 5612 AP The Netherlands
| | - Rhiannon Grant
- Department of Instructive Biomaterials Engineering MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Gozde Sahin
- Department of Instructive Biomaterials Engineering MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Roman K. Truckenmüller
- Department of Instructive Biomaterials Engineering MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Carlijn V. C. Bouten
- Department of Biomedical Engineering Eindhoven University of Technology Eindhoven 5612 AP The Netherlands
| | - Nicholas A. Kurniawan
- Department of Biomedical Engineering Eindhoven University of Technology Eindhoven 5612 AP The Netherlands
| | - Stefan Giselbrecht
- Department of Instructive Biomaterials Engineering MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
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27
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Simcoe MJ, Khawaja AP, Hysi PG, Hammond CJ. Genome-wide association study of corneal biomechanical properties identifies over 200 loci providing insight into the genetic etiology of ocular diseases. Hum Mol Genet 2021; 29:3154-3164. [PMID: 32716492 PMCID: PMC7645703 DOI: 10.1093/hmg/ddaa155] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/02/2020] [Accepted: 07/14/2020] [Indexed: 12/19/2022] Open
Abstract
Corneal hysteresis and corneal resistance factor are parameters that reflect the dynamic biomechanical properties of the cornea and have been shown to be biomarkers of corneal disease. In this genome-wide association study of over 100 000 participants, we identified over 200 genetic loci, all but eight novel, significantly associated with either one or both of these traits. In addition to providing key insights into the genetic architecture underlying normal corneal function, these results identify many candidate loci in the study of corneal diseases that lead to severe visual impairment. Additionally, using Mendelian randomization, we were able to identify causal relationships between corneal biomechanics and intraocular pressure measurements, which help elucidate the relationship between corneal properties and glaucoma.
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Affiliation(s)
- Mark J Simcoe
- Department of Ophthalmology, Kings College London, London, UK, SE1 7EH.,Department of Twins Research and Genetic Epidemiology, Kings College London, London, UK, SE1 7EH.,Institute of Ophthalmology, University College London, London, United Kingdom, EC1V 9EL
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK, EC1V 2PD.,Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK, CB1 8RN
| | - Pirro G Hysi
- Department of Ophthalmology, Kings College London, London, UK, SE1 7EH.,Department of Twins Research and Genetic Epidemiology, Kings College London, London, UK, SE1 7EH.,Institute of Child Health, University College London, London, United Kingdom, WC1N 1EH
| | - Christopher J Hammond
- Department of Ophthalmology, Kings College London, London, UK, SE1 7EH.,Department of Twins Research and Genetic Epidemiology, Kings College London, London, UK, SE1 7EH
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28
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Corneal Biomechanical Changes in Third Trimester of Pregnancy. ACTA ACUST UNITED AC 2021; 57:medicina57060600. [PMID: 34200925 PMCID: PMC8230443 DOI: 10.3390/medicina57060600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/22/2022]
Abstract
Background and Objectives: There is a clear evidence that pregnancy is associated with high production of sex hormones. During the first, second and third trimester of pregnancy, blood hormones levels increase gradually. Cells with affinity for sex hormones have been identified in different ocular tissues, such as: lid, lacrimal gland, meibomian gland, bulbar and palpebral conjunctivae, cornea, iris, ciliary body, lens, retina (retinal pigment epithelium) and choroid. This is why pregnancy is associated with changes at ocular level, involving anterior and posterior segments. Several clinical trials have been made trying to highlight changes in corneal biomechanics during pregnancy. By conducting this review, we want to evaluate both the changes in parameters that define corneal biomechanics and intraocular pressure values in pregnant. Materials and Methods: Following a systematic search in the literature related mainly to changes in corneal biomechanics during pregnancy, focusing on the paper published in the last decade, we included in a meta-analysis the cumulative results of three prospective comparative studies. Results: Important changes in corneal biomechanics (corneal hysteresis and corneal resistance factor) parameters were observed in women in the third trimester of pregnancy, but these variations were not statistically significant. Also, a decrease in intraocular pressure was mentioned in these women, but only the corneal compensation intraocular pressure showed a decrease with statistical significance. Conclusions: A decrease in corneal compensatory intraocular pressure was observed in pregnant women in the third trimester of pregnancy, but without other statistically significant changes resulting from the analysis of the other three parameters (corneal hysteresis, corneal resistance factor and Goldmann-correlated intraocular pressure).
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29
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Tutchenko L, Patel S, Skovron M, Horak O, Voytsekhivskyy O. The effect of corneal crosslinking on the rigidity of the cornea estimated using a modified algorithm for the Schiøtz tonometer. Indian J Ophthalmol 2021; 69:1531-1536. [PMID: 34011736 PMCID: PMC8302317 DOI: 10.4103/ijo.ijo_1820_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: The aim of this study was to test a method for estimating corneal rigidity before and after cross-linking (CXL) using a Schiøtz tonometer. Methods: The study was performed in the Kyiv City Clinical Ophthalmological Hospital “Eye Microsurgical Center”, Ukraine. This was a prospective, consecutive, randomized, masked, case-by-case, clinical study. Corneal rigidity, indicated by the gradient (G) between lg applied weight and corresponding lg scale reading during Schiøtz tonometry, were obtained by increasing (A-mode) then reducing (D-mode) weights by two operators [A] in keratoconus, post-CXL and control subjects for estimation of (i) interoperator and (ii) intersessional errors, (iii) intergroup differences; [B] before and after CXL. Central corneal thickness CCT was measured by scanning slit pachymetry. ANOVA, t tests, linear regression were the statistical tools used. Results: Average interoperator difference (ΔG) was –0.120 (SD = ±0.294, 95%CI = –0.175 to –0.066). A significant correlation between ΔG and the mean of each pair of G values was found (r = –0.196, n = 112, P = 0.038). Intersessional differences in mean G values were insignificant (P > 0.05). There was a significant correlation between G at first session (X1) and difference between sessions (ΔG) [Operator 1, ΔG = 0.598x1–0.461, r = 0.601, n = 27, P = 0.009]. Significant intergroup differences in G were found (Operator 1, one-way ANOVA, F = 4.489, P = 0.014). The difference (Δ) between the pre-(X2) and post-CXL treatment G values was significantly associated with the pre-CXL treatment value (Operator 1, Δ = 1.970x2-1.622, r = 0.642, n = 18, P = <.001). G values were correlated with CCT in keratoconus and post-CXL. Conclusion: Corneal rigidity (G) estimated using the Schiøtz tonometer can be useful for detecting changes after CXL. However, G values are linked to CCT, can vary from time-to-time and the procedure is operator dependent.
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Affiliation(s)
- Larysa Tutchenko
- Department of Ophthalmology, Shupyk National Medical Academy of Postgraduate Education; Kyiv City Clinical Ophthalmological Hospital "Eye Microsurgical Center", Kyiv, Ukraine
| | - Sudi Patel
- NHS National Services Scotland, Edinburgh, UK
| | - Mykhailo Skovron
- Kyiv City Clinical Ophthalmological Hospital "Eye Microsurgical Center", Kyiv, Ukraine
| | - Olha Horak
- Kyiv City Clinical Ophthalmological Hospital "Eye Microsurgical Center", Kyiv, Ukraine
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30
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Wilson A, Marshall J. A review of corneal biomechanics: Mechanisms for measurement and the implications for refractive surgery. Indian J Ophthalmol 2021; 68:2679-2690. [PMID: 33229643 PMCID: PMC7856929 DOI: 10.4103/ijo.ijo_2146_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Detailed clinical assessment of corneal biomechanics has the potential to revolutionize the ophthalmic industry through enabling quicker and more proficient diagnosis of corneal disease, safer and more effective surgical treatments, and the provision of customized and optimized care. Despite these wide-ranging benefits, and an outstanding clinical need, the provision of technology capable of the assessment of corneal biomechanics in the clinic is still in its infancy. While laboratory-based technologies have progressed significantly over the past decade, there remain significant gaps in our knowledge regarding corneal biomechanics and how they relate to shape and function, and how they change in disease and after surgical intervention. Here, we discuss the importance, relevance, and challenges associated with the assessment of corneal biomechanics and review the techniques currently available and underdevelopment in both the laboratory and the clinic.
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Affiliation(s)
- Abby Wilson
- Wolfson School of Mechanical, Manufacturing and Electrical Engineering, Loughborough University, Loughborough, UK
| | - John Marshall
- Wolfson School of Mechanical, Manufacturing and Electrical Engineering, Loughborough University, Loughborough, UK
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31
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Colakoglu A, Colakoglu IE, Cosar CB. Correlation between corneal thickness, keratometry, age, and differential pressure difference in healthy eyes. Sci Rep 2021; 11:4133. [PMID: 33603061 PMCID: PMC7893151 DOI: 10.1038/s41598-021-83683-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/03/2021] [Indexed: 01/31/2023] Open
Abstract
To determine the use of differential pressure difference (DPD), in air-puff differential tonometry, as a potential biomechanical measure of the cornea and elucidate its relationship with the intraocular pressure (IOP), central corneal thickness, corneal curvature, and age. This study comprised 396 eyes from 198 patients and was conducted at Acibadem University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey. The central corneal curvature and refraction of the eyes were measured using an Auto Kerato-Refractometer (KR-1; Topcon Corporation, Tokyo, Japan). IOP and central corneal thickness were measured using a tono-pachymeter (CT-1P; Topcon Corporation, Tokyo, Japan), wherein two separate readings of IOP were obtained using two different modes: 1-30 and 1-60. The difference between these two readings was recorded as the DPD. The factors affecting the DPD were determined by stepwise multiple linear regression analysis. DPD varied over a dynamic range of - 3.0 to + 5.0 mmHg and was weakly correlated with the central corneal thickness (r = 0.115, p < 0.05). DPD showed no significant correlation with IOP 1-30 (p > 0.05). A weak but statistically significant (p < 0.05) positive correlation of DPD was observed with age (r = 0.123), Kavg (r = 0.102), and the CCT (r = 0.115). There was a significant correlation between DPD and Kavg, CCT, and age. There was no significant correlation between DPD and IOP 1-30. Age-related changes in the corneal ultrastructure may be a plausible explanation for the weak positive association between age and DPD. The proposed method may prove a valid non-invasive tool for the evaluation of corneal biomechanics and introduce DPD in the decision-making of routine clinical practice.
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Affiliation(s)
- Ahmet Colakoglu
- Department of Ophthalmology, Acibadem University School of Medicine, Icerenkoy, 34752, Istanbul, Turkey.
| | | | - Cemile Banu Cosar
- Department of Ophthalmology, Acibadem University School of Medicine, Icerenkoy, 34752, Istanbul, Turkey
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32
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Jiang X, Dellepiane N, Pairo-Castineira E, Boutin T, Kumar Y, Bickmore WA, Vitart V. Fine-mapping and cell-specific enrichment at corneal resistance factor loci prioritize candidate causal regulatory variants. Commun Biol 2020; 3:762. [PMID: 33311554 PMCID: PMC7732848 DOI: 10.1038/s42003-020-01497-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/13/2020] [Indexed: 01/08/2023] Open
Abstract
Corneal resistance factor (CRF) is altered during corneal diseases progression. Genome-wide-association studies (GWAS) indicated potential CRF and disease genetics overlap. Here, we characterise 135 CRF loci following GWAS in 76029 UK Biobank participants. Enrichment of extra-cellular matrix gene-sets, genetic correlation with corneal thickness (70% (SE = 5%)), reported keratoconus risk variants at 13 loci, all support relevance to corneal stroma biology. Fine-mapping identifies a subset of 55 highly likely causal variants, 91% of which are non-coding. Genomic features enrichments, using all associated variants, also indicate prominent regulatory causal role. We newly established open chromatin landscapes in two widely-used human cornea immortalised cell lines using ATAC-seq. Variants associated with CRF were significantly enriched in regulatory regions from the corneal stroma-derived cell line and enrichment increases to over 5 fold for variants prioritised by fine-mapping-including at GAS7, SMAD3 and COL6A1 loci. Our analysis generates many hypotheses for future functional validation of aetiological mechanisms.
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Affiliation(s)
- Xinyi Jiang
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Nefeli Dellepiane
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Erola Pairo-Castineira
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Thibaud Boutin
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Yatendra Kumar
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Wendy A Bickmore
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH42XU, UK.
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Wan K, Cheung SW, Wolffsohn JS, Cho P. Repeatability of corneal biomechanics waveform signal parameters derived from Ocular Response Analyzer in children. Cont Lens Anterior Eye 2020; 44:101373. [PMID: 33268269 DOI: 10.1016/j.clae.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the repeatability of waveform signal parameters, measured with the Ocular Response Analyzer (ORA), in children. METHODS Two sets of ORA measurements, with a 10-min break between them, were performed on children, aged six to <11 years old, either wearing single-vision spectacles (SVS) or orthokeratology (ortho-k) lenses. Intraclass correlation coefficients (ICCs) were used to assess agreements between two sets of measurements (37 waveform signal parameters). Bland-Altman (BA) plots were used to further analyse waveform signal parameters which had ICC 95 % confidence interval (95 % CI) between 0.50 to >0.90 (regarded as moderate to excellent agreement). RESULTS A total of 30 participants [15 SVS, 15 ortho-k (3.6 ± 2.4 months)] completed the study. Since no significant between-group differences were detected in demographic data (p > 0.28) and all waveform signal parameters (p > 0.05), data from the two groups of participants were pooled for the analysis of repeatability. Six parameters, h2, h21, p1area, p1area1, p2area, and p2area1, achieved ICCs (95 % CI) of 0.82-0.85 (0.61-0.93). The mean (SD) of these six parameters were 372 (91), 248 (61), 4077 (854), 1762 (399), 2359 (670), and 1020 (300), respectively. Bland-Altman plots and 95 % limits of agreement (95 % LoA) showed considerable agreement for all six parameters, the mean difference (95 % LoA) were -3 (-101 to 94), -2 (-67.56-62.70), 111 (-723 to 946), 102 (-334 to 539), 25 (-718 to 768), and -3 (-350 to 343), respectively. CONCLUSIONS Six waveform signal parameters (h2, h21, p1area, p1area1, p2area, and p2area1), which represent or are related to the areas under the waveform at the peaks in the signal, had moderate to excellent agreement in children. Results of the current study provides fundamental information for further studies on the potential clinical application of these waveform signal parameters in children.
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Affiliation(s)
- Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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Van Hout CV, Tachmazidou I, Backman JD, Hoffman JD, Liu D, Pandey AK, Gonzaga-Jauregui C, Khalid S, Ye B, Banerjee N, Li AH, O'Dushlaine C, Marcketta A, Staples J, Schurmann C, Hawes A, Maxwell E, Barnard L, Lopez A, Penn J, Habegger L, Blumenfeld AL, Bai X, O'Keeffe S, Yadav A, Praveen K, Jones M, Salerno WJ, Chung WK, Surakka I, Willer CJ, Hveem K, Leader JB, Carey DJ, Ledbetter DH, Cardon L, Yancopoulos GD, Economides A, Coppola G, Shuldiner AR, Balasubramanian S, Cantor M, Nelson MR, Whittaker J, Reid JG, Marchini J, Overton JD, Scott RA, Abecasis GR, Yerges-Armstrong L, Baras A. Exome sequencing and characterization of 49,960 individuals in the UK Biobank. Nature 2020; 586:749-756. [PMID: 33087929 PMCID: PMC7759458 DOI: 10.1038/s41586-020-2853-0] [Citation(s) in RCA: 283] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/25/2020] [Indexed: 12/12/2022]
Abstract
The UK Biobank is a prospective study of 502,543 individuals, combining extensive phenotypic and genotypic data with streamlined access for researchers around the world1. Here we describe the release of exome-sequence data for the first 49,960 study participants, revealing approximately 4 million coding variants (of which around 98.6% have a frequency of less than 1%). The data include 198,269 autosomal predicted loss-of-function (LOF) variants, a more than 14-fold increase compared to the imputed sequence. Nearly all genes (more than 97%) had at least one carrier with a LOF variant, and most genes (more than 69%) had at least ten carriers with a LOF variant. We illustrate the power of characterizing LOF variants in this population through association analyses across 1,730 phenotypes. In addition to replicating established associations, we found novel LOF variants with large effects on disease traits, including PIEZO1 on varicose veins, COL6A1 on corneal resistance, MEPE on bone density, and IQGAP2 and GMPR on blood cell traits. We further demonstrate the value of exome sequencing by surveying the prevalence of pathogenic variants of clinical importance, and show that 2% of this population has a medically actionable variant. Furthermore, we characterize the penetrance of cancer in carriers of pathogenic BRCA1 and BRCA2 variants. Exome sequences from the first 49,960 participants highlight the promise of genome sequencing in large population-based studies and are now accessible to the scientific community.
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Affiliation(s)
| | | | | | - Joshua D Hoffman
- GlaxoSmithKline, Collegeville, PA, USA.,Foresite Labs, Cambridge, MA, USA
| | - Daren Liu
- Regeneron Genetics Center, Tarrytown, NY, USA
| | | | | | | | - Bin Ye
- Regeneron Genetics Center, Tarrytown, NY, USA
| | | | | | | | | | | | - Claudia Schurmann
- Regeneron Genetics Center, Tarrytown, NY, USA.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | - John Penn
- Regeneron Genetics Center, Tarrytown, NY, USA.,DNANexus, Mountain View, CA, USA
| | | | | | | | | | | | | | | | | | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.,Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Kristian Hveem
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | - Matthew R Nelson
- GlaxoSmithKline, Collegeville, PA, USA.,Deerfield, New York, NY, USA
| | | | | | | | | | | | | | | | - Aris Baras
- Regeneron Genetics Center, Tarrytown, NY, USA.
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35
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Taroni L, Bernabei F, Pellegrini M, Roda M, Toschi PG, Mahmoud AM, Schiavi C, Giannaccare G, Roberts CJ. Corneal Biomechanical Response Alteration After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment. Am J Ophthalmol 2020; 217:49-54. [PMID: 32283097 DOI: 10.1016/j.ajo.2020.03.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare the corneal biomechanics of eyes that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) with those of fellow eyes (fellow eyes) and to further investigate the effects of SB on intraocular pressure (IOP) values. DESIGN Retrospective, fellow-eye matched cohort study. METHODS A total of 18 consecutive patients (11 males and 7 females) treated with SB for RRD in 1 eye were enrolled. Goldmann applanation tonometry was used to measure IOP. Biomechanical properties of the cornea were investigated by using the Ocular Response Analyzer (ORA) (Reichert Instruments) for the calculation of corneal resistant factor (CRF), corneal hysteresis, Goldmann-correlated IOP, and corneal-compensated IOP. Customized software was used for analysis of the ORA infrared and pressure signals, and a significance threshold was set to a P value of .05. RESULTS Operated eyes (OEs) showed significantly lower values of corneal hysteresis and CRF than fellow eyes (9.0 ± 1.8 vs 10.1 ± 1.8 mm Hg, respectively; P < .001; 10.0 ± 2.2 vs 10.9 ± 2.2 mm Hg; P < .001). GAT was significantly lower than corneal-compensated IOP in OEs (18.1 ± 4.9 vs 19.8 ± 4.8 mm Hg, respectively; P = .022) but not in fellow eyes. The second applanation event (A2) took place earlier in time, and the cornea was moving faster during A2 in the OEs than in the fellow eyes. CONCLUSIONS SB for the treatment of RRD affects corneal biomechanical response, likely due to a less compliant sclera that limits corneal motion and reduces energy dissipation, reflected in a lower corneal hysteresis. This has potentially meaningful clinical implications as the accuracy of the measurement of IOP values may be affected in these eyes.
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Affiliation(s)
- Leonardo Taroni
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
| | - Federico Bernabei
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Marco Pellegrini
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Matilde Roda
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Pier Giorgio Toschi
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Ashraf M Mahmoud
- Department of Ophthalmology and Visual Science and Department of Biomedical Engineering, Ohio State University, Columbus, Ohio, USA
| | - Costantino Schiavi
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy; Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Science and Department of Biomedical Engineering, Ohio State University, Columbus, Ohio, USA
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Hernández Esteban L, Orduña Domingo E. Descemet membrane endothelial keratoplasty and corneal biomechanics. ACTA ACUST UNITED AC 2020; 95:429-438. [PMID: 32576401 DOI: 10.1016/j.oftal.2020.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To study the behaviour of the biomechanical properties of the cornea in DMEK (Descemet membrane endothelial keratoplasty). METHOD Prospective longitudinal observational study. 21 pre and post-DMEK eyes. 3-month follow-up with the dynamic Scheimpflug Analyzer (Corvis ST, Oculus; Wetzlar, Germany). The following parameters were measured: IOPnc: non-corrected intraocular pressure (IOP), IOPb: IOP corrected by biomechanics, maximum deflection amplitude (DefA), CCT: central corneal pachymetry, flattening speed 1 and 2, peak distance, HC deformation amplitude: deformation amplitude in maximum concavity, integrated inverse concave radius, DAR 1 and 2: deformation amplitude at 1mm and 2mm from the corneal apex, respectively. ARTh: Ambrosial pachymetric ratio, SP1: stiffness parameter, CBI: Corvis Biomechanical index and the maximum inverse radius. Pre-operative and post-operative measurements were performed with a 3-month follow-up and compared with a paired sample t-test. RESULTS There was a significant decrease in the IOPnc of 1.54±3mmHg (p<0.05), a significant increase in the post-surgical IOPb of 3.79±3.18mmHg (p<0.001), a significant pachymetric decrease of 164.4±91.35μm (p<0.001) after the intervention. All dynamic parameters of the Scheimpflug analyzer changed significantly after surgery (p<0.05), except the ARTh and IWC variables. CONCLUSIONS Variables indicate a decrease in corneal strength post-DMEK, with an increase in IOPb, at least the first 3 months after surgery. This finding is especially relevant in the follow-up of patients with coexisting glaucoma.
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Fernández-Pérez J, Kador KE, Lynch AP, Ahearne M. Characterization of extracellular matrix modified poly(ε-caprolactone) electrospun scaffolds with differing fiber orientations for corneal stroma regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 108:110415. [DOI: 10.1016/j.msec.2019.110415] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 10/25/2022]
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Jędzierowska M, Koprowski R, Wilczyński S, Krysik K. A new method for detecting the outer corneal contour in images from an ultra-fast Scheimpflug camera. Biomed Eng Online 2019; 18:115. [PMID: 31796067 PMCID: PMC6888987 DOI: 10.1186/s12938-019-0735-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 11/22/2019] [Indexed: 01/28/2023] Open
Abstract
Background The Corvis® ST tonometer is an innovative device which, by combining a classic non-contact tonometer with an ultra-fast Scheimpflug camera, provides a number of parameters allowing for the assessment of corneal biomechanics. The acquired biomechanical parameters improve medical diagnosis of selected eye diseases. One of the key elements in biomechanical measurements is the correct corneal contour detection, which is the basis for further calculations. The presented study deals with the problem of outer corneal edge detection based on a series of images from the afore-mentioned device. Corneal contour detection is the first and extremely important stage in the acquisition and analysis of corneal dynamic parameters. Result A total of 15,400 images from the Corvis® ST tonometer acquired from 110 patients undergoing routine ophthalmologic examinations were analysed. A method of outer corneal edge detection on the basis of a series of images from the Corvis® ST was proposed. The method was compared with known and commonly used edge detectors: Sobel, Roberts, and Canny operators, as well as others, known from the literature. The analysis was carried out in MATLAB® version 9.0.0.341360 (R2016a) with the Image Processing Toolbox (version 9.4) and the Neural Network Toolbox (version 9.0). The method presented in this paper provided the smallest values of the mean error (0.16%), stability (standard deviation 0.19%) and resistance to noise, characteristic for Corvis® ST tonometry tests, compared to the methods known from the literature. The errors were 5.78 ± 9.19%, 3.43 ± 6.21%, and 1.26 ± 3.11% for the Roberts, Sobel, and Canny methods, respectively. Conclusions The proposed new method for detecting the outer corneal contour increases the accuracy of intraocular pressure measurements. It can be used to analyse dynamic parameters of the cornea.
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Affiliation(s)
- Magdalena Jędzierowska
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, ul. Będzińska 39, 41-200, Sosnowiec, Poland.
| | - Robert Koprowski
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, ul. Będzińska 39, 41-200, Sosnowiec, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa Street 3, 41-200, Sosnowiec, Poland
| | - Katarzyna Krysik
- Department of Ophthalmology with Paediatric Unit, St. Barbara Hospital, Trauma Centre, Plac Medykow 1, 41-200, Sosnowiec, Poland
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Uyanıklar M, Günal G, Tevlek A, Hosseinian P, Aydin HM. Hybrid Cornea: Cell Laden Hydrogel Incorporated Decellularized Matrix. ACS Biomater Sci Eng 2019; 6:122-133. [DOI: 10.1021/acsbiomaterials.9b01286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Impact of Corneoscleral Contact Lens Usage on Corneal Biomechanical Parameters in Keratoconic Eyes. Eye Contact Lens 2019; 45:318-323. [DOI: 10.1097/icl.0000000000000579] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lam AKC, Hon Y, Leung SYY, Shu-Ho L, Chong J, Lam DCC. Association between long-term orthokeratology responses and corneal biomechanics. Sci Rep 2019; 9:12566. [PMID: 31467346 PMCID: PMC6715748 DOI: 10.1038/s41598-019-49041-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/19/2019] [Indexed: 12/22/2022] Open
Abstract
Myopia is very prevalent worldwide, especially among Asian populations. Orthokeratology is a proven intervention to reduce myopia progression. The current study investigated association between baseline corneal biomechanics and orthokeratology responses, and changes of corneal biomechanics from long-term orthokeratology. We fitted 59 adult subjects having myopia between −4.00D to −5.00D with overnight orthokeratology. Corneal biomechanics was measured through dynamic bidirectional corneal applanation (in terms of corneal hysteresis, CH and corneal resistance factor, CRF) and corneal indentation (in terms of corneal stiffness, S and tangent modulus, E). Subjects with poor orthokeratology responses had lower E (mean 0.474 MPa) than subjects with good orthokeratology responses (mean 0.536 MPa). Successful orthokeratology for 6 months resulted in reducing CH (reduced by 5.8%) and CRF (reduced by 8.7%). Corneal stiffness was stable, but E showed an increasing trend. Among subjects with successful orthokeratology, a higher baseline S resulted in greater myopia reduction (Pearson correlation coefficient, r = 0.381, p = 0.02).
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Affiliation(s)
- Andrew K C Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Ying Hon
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Stanley Y Y Leung
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Lu Shu-Ho
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Jones Chong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - David C C Lam
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
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Hong H, Park SM, Kim D, Park SJ, Kim DS. Grayscale mask‐assisted photochemical crosslinking for a dense collagen construct with stiffness gradient. J Biomed Mater Res B Appl Biomater 2019; 108:1000-1009. [DOI: 10.1002/jbm.b.34452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 06/12/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Hyeonjun Hong
- Department of Mechanical EngineeringPohang University of Science and Technology (POSTECH) 77 Cheongam‐ro, Pohang Gyeongbuk 37673 South Korea
| | - Sang Min Park
- Department of Mechanical EngineeringPohang University of Science and Technology (POSTECH) 77 Cheongam‐ro, Pohang Gyeongbuk 37673 South Korea
| | - Dohui Kim
- Department of Mechanical EngineeringPohang University of Science and Technology (POSTECH) 77 Cheongam‐ro, Pohang Gyeongbuk 37673 South Korea
| | - Sung Jea Park
- Advanced Technology Research Center & School of Mechanical EngineeringKorea University of Technology and Education (KOREATECH) Cheonan Chungnam 31253 South Korea
| | - Dong Sung Kim
- Department of Mechanical EngineeringPohang University of Science and Technology (POSTECH) 77 Cheongam‐ro, Pohang Gyeongbuk 37673 South Korea
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Michaud L. Longitudinal study on ocular manifestations in a cohort of patients with Fabry disease. PLoS One 2019; 14:e0213329. [PMID: 31246960 PMCID: PMC6597042 DOI: 10.1371/journal.pone.0213329] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 05/26/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose This study aims to assess the evolution of ocular manifestations in a cohort of Fabry patients. Methods This is a prospective observational study conducted from 2013 to 2017 (5 consecutive exams). All subjects underwent a comprehensive ocular examination including oriented case history, refraction, corneal topography, biomechanical corneal properties and pachometry assessments, aberrometry, anterior segment evaluation, double-frequency visual field (FDT), intra-ocular pressure, and ocular fundus. At baseline, 41 subjects enrolled but 9 dropped-out and 4 files were not kept for analysis (missing data). Remaining 28 subjects were classified into: Group 1 -hemizygotes (HMZ), all on enzyme replacement therapy (ERT) (N = 10); Group 2 -heterozygotes (HTZ) actively ERT-treated (N = 8), and Group 3 -HTZ not treated (N = 10). Results There is a high intra and inter-subjects variability. At baseline, prevalence of the ocular manifestations found is similar to published data: cornea verticillata (89.2%), conjunctival vessels tortuosity (85.7%), corneal haze (67.8%), retinal vessels tortuosity (64.2%), anterior cataract (39.2%) and posterior cataract (28.5%). Prevalence for new elements are found: upper lid vessels toricity (96.4%) and micro-aneurysms (42.8%). At the end, micro-aneurysms (+82%), posterior cataract (+75%) corneal haze (+21%) anterior cataract (+17%) and retinal vessels tortuosities (+4%) evolved in prevalence and severity despite the fact that 68% of the patients were on ERT. Treated heterozygotes evolved more than other groups (p>0.05). Conclusion ERT does not seem to halt the clinical evolution of several ocular manifestations. Longer observational time and objective grading systems may be required to fully confirm these findings.
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Affiliation(s)
- Langis Michaud
- École d’optométrie, Université de Montréal, Montréal, Québec, Canada
- * E-mail:
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Duarte Campos DF, Rohde M, Ross M, Anvari P, Blaeser A, Vogt M, Panfil C, Yam GH, Mehta JS, Fischer H, Walter P, Fuest M. Corneal bioprinting utilizing collagen‐based bioinks and primary human keratocytes. J Biomed Mater Res A 2019; 107:1945-1953. [DOI: 10.1002/jbm.a.36702] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Daniela F. Duarte Campos
- Department of Dental Materials and Biomaterials ResearchRWTH Aachen University Hospital Aachen Germany
| | - Malena Rohde
- Department of OphthalmologyRWTH Aachen University Hospital Aachen Germany
| | - Mitchell Ross
- Department of Dental Materials and Biomaterials ResearchRWTH Aachen University Hospital Aachen Germany
- Department of Chemical EngineeringMcMaster University Hamilton Canada
| | - Parham Anvari
- Department of Dental Materials and Biomaterials ResearchRWTH Aachen University Hospital Aachen Germany
| | - Andreas Blaeser
- Department of Dental Materials and Biomaterials ResearchRWTH Aachen University Hospital Aachen Germany
- Medical Textiles and Biofabrication, Institute for Textile Technology (ITA)RWTH Aachen University Aachen Germany
| | - Michael Vogt
- Interdisciplinary Center for Clinical Research IZKFRWTH Aachen University Hospital Aachen Germany
| | - Claudia Panfil
- Aachen Center for Technology Transfer in Ophthalmology (ACTO) Aachen Germany
| | - Gary Hin‐Fai Yam
- Tissue Engineering and Stem Cell GroupSingapore Eye Research Institute Singapore Singapore
| | - Jodhbir S. Mehta
- Tissue Engineering and Stem Cell GroupSingapore Eye Research Institute Singapore Singapore
- Singapore National Eye Centre Singapore Singapore
| | - Horst Fischer
- Department of Dental Materials and Biomaterials ResearchRWTH Aachen University Hospital Aachen Germany
| | - Peter Walter
- Department of OphthalmologyRWTH Aachen University Hospital Aachen Germany
| | - Matthias Fuest
- Department of OphthalmologyRWTH Aachen University Hospital Aachen Germany
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Changes in Corneal Wound Healing and Graft Biomechanics After Primary Penetrating Keratoplasty Versus Repeat Penetrating Keratoplasty. Cornea 2019; 38:1006-1010. [DOI: 10.1097/ico.0000000000001928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chua SYL, Thomas D, Allen N, Lotery A, Desai P, Patel P, Muthy Z, Sudlow C, Peto T, Khaw PT, Foster PJ. Cohort profile: design and methods in the eye and vision consortium of UK Biobank. BMJ Open 2019; 9:e025077. [PMID: 30796124 PMCID: PMC6398663 DOI: 10.1136/bmjopen-2018-025077] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/01/2018] [Accepted: 12/11/2018] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To describe the rationale, methods and research potential of eye and vision measures available in UK Biobank. PARTICIPANTS UK Biobank is a large, multisite, prospective cohort study. Extensive lifestyle and health questionnaires, a range of physical measures and collection of biological specimens are collected. The scope of UK Biobank was extended midway through data collection to include assessments of other measures of health, including eyes and vision. The eye assessment at baseline included questionnaires detailing past ophthalmic and family history, measurement of visual acuity, refractive error and keratometry, intraocular pressure (IOP), corneal biomechanics, spectral domain optical coherence tomography (OCT) of the macula and a disc-macula fundus photograph. Since recruitment, UK Biobank has collected accelerometer data and begun multimodal imaging data (including brain, heart and abdominal MRI) in 100 000 participants. Dense genotypic data and a panel of 20 biochemistry measures are available, and linkage to medical health records for the full cohort has begun. FINDINGS TO DATE A total of 502 665 people aged between 40 and 69 were recruited to participate in UK Biobank. Of these, 117 175 took part in baseline assessment of vision, IOP, refraction and keratometry. A subgroup of 67 321 underwent OCT and retinal photography. The introduction of eye and vision measures in UK Biobank was accompanied by intensive training, support and a data monitoring quality control process. FUTURE PLANS UK Biobank is one of the largest prospective cohorts worldwide with extensive data on ophthalmic diseases and conditions. Data collection is an ongoing process and a repeat of the baseline assessment including the questionnaires, measurements and sample collection will be performed in subsets of 25 000 participants every 2-3 years. The depth and breadth of this dataset, coupled with its open-access policy, will create a powerful resource for all researchers to investigate the eye diseases in later life.
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Affiliation(s)
- Sharon Yu Lin Chua
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Dhanes Thomas
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Naomi Allen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andrew Lotery
- Department of Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Parul Desai
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Praveen Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Zaynah Muthy
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Cathie Sudlow
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tunde Peto
- Institute of Clinical Science, Queen's University Belfast Faculty of Medicine Health and Life Sciences, Belfast, Belfast, UK
| | - Peng Tee Khaw
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Moshirfar M, Motlagh MN, Murri MS, Momeni-Moghaddam H, Ronquillo YC, Hoopes PC. Advances in Biomechanical Parameters for Screening of Refractive Surgery Candidates: A Review of the Literature, Part III. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:219-240. [PMID: 31598522 PMCID: PMC6778467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Corneal biomechanical properties have garnered significant interest in their relation to the development of ectatic corneal disease. Alongside the advent of corneal tomography and Scheimpflug imaging such as Pentacam and Galilei, there have been advances in assessing the cornea based on its biomechanical characteristics. Though the aforementioned imaging systems are highly capable of identifying morphologic abnormalities, they cannot assess mechanical stability of the cornea. This article, in contrast to Parts I and II of this article series, will focus on in vivo corneal biomechanical imaging systems. The two most readily available commercial systems include the Corvis ST and the Ocular Response Analyzer. Both of these systems aimed to characterize corneal biomechanics via distinct measurements. While in Parts I and II of this article series the authors focused on elevation, pachymetric, and keratometric data, the purpose of this article was to summarize biomechanical parameters and their clinical use in screening refractive surgery candidates. Moreover, this article explores biomechanical decompensation and its role in the development of corneal ectasia and keratoconus. There is a focus on the diagnostic accuracy of biomechanical indices in the identification of diseases such as keratoconus that may preclude a patient from undergoing refractive surgery.
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Affiliation(s)
- Majid Moshirfar
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, School of Medicine, University of Utah, Salt Lake City, UT, USA
- HDR Research Center, Hoopes Vision, Draper, UT, USA
| | - Mahsaw N. Motlagh
- Department of Ophthalmology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Michael S. Murri
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Hamed Momeni-Moghaddam
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Potop V, Corbu C, Coviltir V, Schmitzer S, Constantin M, Burcel M, Ionescu C, Dăscălescu D. The importance of corneal assessment in a glaucoma suspect - a review. Rom J Ophthalmol 2019; 63:321-326. [PMID: 31915729 PMCID: PMC6943289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Glaucoma represents the main cause of irreversible blindness in the world and for this consideration, the interest in a quick and precise diagnosis and progression of the disease, prior to the appearance of irreversible damage, has been continuously rising. Glaucoma risk factors are already well known, but current studies reveal that it is necessary to make a proper analysis of the intraocular pressure (IOP) to obtain an accurate diagnosis, so we must take into consideration corneal properties that might affect IOP measurements. Starting from corneal geometrical properties represented by central corneal thickness (CCT) and continuing with biomechanical properties represented by corneal hysteresis (CH) and corneal resistance factor (CRF) we reviewed the value of investigating corneal properties in ocular hypertension (OH), primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients. We can now say that CCT plays an important role in diagnosing glaucoma because it may mask the real value of the IOP and also, in setting the target for the IOP needed to stop disease progression. Also, CH is a factor that needs to be screened from the first consult of a glaucoma patient or suspect because it is correlated to the response to treatment, visual field (VF) and retinal nerve fiber layer (RNFL) progression and could anticipate the future evolution and patients prognosis. Both CCT and CH are factors that must be thought-about when we encounter a glaucoma suspect. CCT has a predictive role in OH and NTG patients, while CH has on the other hand a prognostic role in POAG, OH and NTG patients.
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Affiliation(s)
- Vasile Potop
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | - Cătălina Corbu
- Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | - Valeria Coviltir
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | - Speranţa Schmitzer
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | | | | | | | - Dana Dăscălescu
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Oftaclinic Bucharest, Romania
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Goodarzi H, Jadidi K, Pourmotabed S, Sharifi E, Aghamollaei H. Preparation and in vitro characterization of cross-linked collagen-gelatin hydrogel using EDC/NHS for corneal tissue engineering applications. Int J Biol Macromol 2018; 126:620-632. [PMID: 30562517 DOI: 10.1016/j.ijbiomac.2018.12.125] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 02/02/2023]
Abstract
Corneal disease is considered as the second leading cause of vision loss and keratoplasty is known as an effective treatment for it. However, the tissue engineered corneal substitutes are promising tools in experimental in vivo repair of cornea. Selecting appropriate cell sources and scaffolds are two important concerns in corneal tissue engineering. The object of this study was to investigate biocompatibility and physical properties of the bio-engineered cornea, fabricated from type-I collagen (COL) and gelatin (Gel). Two gelatin based hydrogels cross-linked with EDC/NHS were fabricated, and their physicochemical properties such as equilibrium water content, enzymatic degradation, mechanical properties, rheological, contact angle and optical properties as well as their ability to support human bone-marrow mesenchymal stem cells (hBM-MSCs) survival were characterized. The equilibrium water content and enzymatic degradation of these hydrogels can be easily controlled by adding COL. Our findings suggest that incorporation of COL-I increases optical properties, hydrophilicity, stiffness and Young's modulus. The viability of hBM-MSCs cultured in Gel and Gel: COL was assessed via CCK-8 assay. Also, the morphology of the hBM-MSCs on the top of Gel and Gel: COL hydrogels were characterized by phase-contrast microscopy. This biocompatible hydrogel may promise to be used as artificial corneal substitutes.
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Affiliation(s)
- Hamid Goodarzi
- Department of Biomedical Engineering, Faculty of Chemical Engineering, Tarbiat Modares University, Tehran, Iran
| | - Khosrow Jadidi
- Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Samiramis Pourmotabed
- Department of Emergency Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Esmaeel Sharifi
- Department of Molecular Medicine and Genetics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; Department of Tissue Engineering and Biomaterials, School of Advanced Medical Sciences and Technologies, Hamadan University of Medical Sciences, Hamadan, Iran..
| | - Hossein Aghamollaei
- Chemical Injuries Research Center, Systems biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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