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Vijayaraghavan R, Loganathan S, Valapa RB. Fabrication of GelMA - Agarose Based 3D Bioprinted Photocurable Hydrogel with In Vitro Cytocompatibility and Cells Mirroring Natural Keratocytes for Corneal Stromal Regeneration. Macromol Biosci 2024:e2400136. [PMID: 39096155 DOI: 10.1002/mabi.202400136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/26/2024] [Indexed: 08/05/2024]
Abstract
The complex anatomy of the cornea and the subsequent keratocyte-fibroblast transition have always made corneal stromal regeneration difficult. Recently, 3D printing has received considerable attention in terms of fabrication of scaffolds with precise dimension and pattern. In the current work, 3D printable polymer hydrogels made of GelMA/agarose are formulated and its rheological properties are evaluated. Despite the variation in agarose content, both the hydrogels exhibited G'>G'' modulus. A prototype for 3D stromal model is created using Solid Works software, mimicking the anatomy of an adult cornea. The fabrication of 3D-printed hydrogels is performed using pneumatic extrusion. The FTIR analysis speculated that the hydrogel is well crosslinked and established strong hydrogen bonding with each other, thus contributing to improved thermal and structural stability. The MTT analysis revealed a higher rate of cell proliferation on the hydrogels. The optical analysis carried out on the 14th day of incubation revealed that the hydrogels exhibit transparency matching with natural corneal stromal tissue. Specific protein marker expression confirmed the keratocyte phenotype and showed that the cells do not undergo terminal differentiation into stromal fibroblasts. The findings of this work point to the potential of GelMA/A hydrogels as a novel biomaterial for corneal stromal tissue engineering.
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Affiliation(s)
- Renuka Vijayaraghavan
- Electrochemical Process Engineering, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi, Tamil Nadu, 630003, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Sravanthi Loganathan
- Electrochemical Process Engineering, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi, Tamil Nadu, 630003, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Ravi Babu Valapa
- Electrochemical Process Engineering, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi, Tamil Nadu, 630003, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
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Tjoa K, Nadhif MH, Utami SS, Kusuma SR, Astagiri PY, Adriono GA. Mechanical, optical, chemical, and biological evaluations of fish scale-derived scaffold for corneal replacements: A systematic review. Int J Biol Macromol 2024; 267:131183. [PMID: 38580016 DOI: 10.1016/j.ijbiomac.2024.131183] [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: 01/04/2024] [Revised: 03/03/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024]
Abstract
Corneal blindness is commonly treated through corneal replacement with allogeneic corneal donors, which may face shortage. Regarding this issue, xenogeneic alternatives are explored. Fish scale-derived scaffolds (FSSs) are among the alternatives due to the lower risk of infection and abundant sources of raw materials. Unfortunately, the information about mechanical, optical, chemical, and biological performances of FSSs for corneal replacements is still scattered, as well as about the fabrication techniques. This study aims to gather scattered pieces of information about the mentioned performances and fabrication techniques of FSSs for corneal replacements. Sorted from four scientific databases and using the PRISMA checklist, eleven relevant articles are collected. FSSs are commonly fabricated using decellularization and decalcification processes, generating FSSs with parallel multilayers or crossed fibers with topographic microchannels. In the collected studies, similar mechanical properties of FSSs to native tissues are discovered, as well as good transparency, light remittance, but poorer refractive indexes than native tissues. Biological evaluations mostly discuss histology, cell proliferations, and immune responses on FSSs, while only a few studies examine the vascularization. No studies completed comprehensive evaluations on the four properties. The current progress of FSS developments demonstrates the potential of FSS use for corneal replacements.
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Affiliation(s)
- Kevin Tjoa
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Muhammad Hanif Nadhif
- Botnar Research Centre, University of Oxford, Oxford, United Kingdom; Department of Medical Physiology and Biophysics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Medical Technology Cluster, Indonesian Medical Education and Research Institute, Jakarta, Indonesia.
| | | | | | - Prasandhya Yusuf Astagiri
- Department of Medical Physiology and Biophysics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Medical Technology Cluster, Indonesian Medical Education and Research Institute, Jakarta, Indonesia
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3
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Lee GW, Chandrasekharan A, Roy S, Thamarappalli A, Mahaling B, Lee H, Seong KY, Ghosh S, Yang SY. 3D bioprinting of stromal cells-laden artificial cornea based on visible light-crosslinkable bioinks forming multilength networks. Biofabrication 2024; 16:035002. [PMID: 38507802 DOI: 10.1088/1758-5090/ad35eb] [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: 02/09/2023] [Accepted: 03/20/2024] [Indexed: 03/22/2024]
Abstract
3D bioprinting has the potential for the rapid and precise engineering of hydrogel constructs that can mimic the structural and optical complexity of a healthy cornea. However, the use of existing light-activated bioinks for corneal printing is limited by their poor cytocompatibility, use of cytotoxic photoinitiators (PIs), low photo-crosslinking efficiency, and opaque/colored surface of the printed material. Herein, we report a fast-curable, non-cytotoxic, optically transparent bioprinting system using a new water-soluble benzoyl phosphinate-based PI and photocrosslinkable methacrylated hyaluronic acid (HAMA). Compared with commercially available PIs, the newly developed PI, lithium benzoyl (phenyl) phosphinate (BP), demonstrated increased photoinitiation efficiency under visible light and low cytotoxicity. Using a catalytic amount of BP, the HA-based bioinks quickly formed 3D hydrogel constructs under low-energy visible-light irradiation (405 nm, <1 J cm-2). The mechanical properties and printability of photocurable bioinks were further improved by blending low (10 kDa) and high (100 kDa) molecular weight (MW) HAMA by forming multilength networks. For potential applications as corneal scaffolds, stromal cell-laden dome-shaped constructs were fabricated using MW-blended HAMA/BP bioink and a digital light processing printer. The HA-based photocurable bioinks exhibited good cytocompatibility (80%-95%), fast curing kinetics (<5 s), and excellent optical transparency (>90% in the visible range), potentially making them suitable for corneal tissue engineering.
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Affiliation(s)
- Gyeong Won Lee
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Ajeesh Chandrasekharan
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Subhadeep Roy
- Department of Textile and Fibre Engineering, Indian Institute of Technology, Delhi 110016, India
| | - Akash Thamarappalli
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Binapani Mahaling
- Department of Textile and Fibre Engineering, Indian Institute of Technology, Delhi 110016, India
| | - Hyeseon Lee
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Keum-Yong Seong
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
| | - Sourabh Ghosh
- Department of Textile and Fibre Engineering, Indian Institute of Technology, Delhi 110016, India
| | - Seung Yun Yang
- Department of Biomaterials Science (BK21 Four Program), Pusan National University, Miryang 50463, Republic of Korea
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4
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Vijayaraghavan R, Loganathan S, Valapa RB. 3D bioprinted photo crosslinkable GelMA/methylcellulose hydrogel mimicking native corneal model with enhanced in vitro cytocompatibility and sustained keratocyte phenotype for stromal regeneration. Int J Biol Macromol 2024; 264:130472. [PMID: 38428773 DOI: 10.1016/j.ijbiomac.2024.130472] [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: 08/31/2023] [Revised: 02/15/2024] [Accepted: 02/25/2024] [Indexed: 03/03/2024]
Abstract
Corneal transplantation serves as the standard clinical therapy for serious corneal disorders. However, rejection of grafts, significant expenditures, and most crucially, the global donor shortage, may affect the outcome. Recently, 3D bioprinting using biodegradable polymeric materials has become a suitable method for creating tissue replicas with identical architecture. One such most renowned material is GelMA, for its scaffold's three-dimensional structure, biocompatibility, robust mechanics, and favourable optical transmittance. However, GelMA's inadequate viscosity to print at body temperature with better form integrity remains an obstacle. The aim of this work is to create 3D printed GelMA/MC hydrogels for corneal stroma tissue engineering using MC's printability at room temperature and GelMA's irreversible photo cross-linking with UV irradiation. The print speed and pressure conditions for 3D GelMA/MC hydrogels were tuned. Thermal, morphological and physicochemical characteristics were studied for two distinct concentrations of GelMA/MC hydrogels. The hydrogels achieved a transparency of ~78 % (at 700 nm), which was on par with that of the normal cornea (80 %). The in vitro studies conducted using goat corneal stromal cells demonstrated the ability of both hydrogels to promote cell adhesion and proliferation. Expression of Vimentin and keratan sulphate validated the phenotype of keratocytes in the hydrogel. This 3D printed GelMA/MC hydrogel model mimics biophysical characteristics of the native corneal stroma, which may hold promise for clinical corneal stromal tissue engineering.
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Affiliation(s)
- Renuka Vijayaraghavan
- Electrochemical Process Engineering, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi 630003, Tamil Nadu, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Sravanthi Loganathan
- Electrochemical Process Engineering, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi 630003, Tamil Nadu, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
| | - Ravi Babu Valapa
- Electrochemical Process Engineering, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi 630003, Tamil Nadu, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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5
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Whalen M, Akula M, McNamee SM, DeAngelis MM, Haider NB. Seeing the Future: A Review of Ocular Therapy. Bioengineering (Basel) 2024; 11:179. [PMID: 38391665 PMCID: PMC10886198 DOI: 10.3390/bioengineering11020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
Ocular diseases present a unique challenge and opportunity for therapeutic development. The eye has distinct advantages as a therapy target given its accessibility, compartmentalization, immune privilege, and size. Various methodologies for therapeutic delivery in ocular diseases are under investigation that impact long-term efficacy, toxicity, invasiveness, and delivery range. While gene, cell, and antibody therapy and nanoparticle delivery directly treat regions that have been damaged by disease, they can be limited in the duration of the therapeutic delivery and have a focal effect. In contrast, contact lenses and ocular implants can more effectively achieve sustained and widespread delivery of therapies; however, they can increase dilution of therapeutics, which may result in reduced effectiveness. Current therapies either offer a sustained release or a broad therapeutic effect, and future directions should aim toward achieving both. This review discusses current ocular therapy delivery systems and their applications, mechanisms for delivering therapeutic products to ocular tissues, advantages and challenges associated with each delivery system, current approved therapies, and clinical trials. Future directions for the improvement in existing ocular therapies include combination therapies, such as combined cell and gene therapies, as well as AI-driven devices, such as cortical implants that directly transmit visual information to the cortex.
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Affiliation(s)
- Maiya Whalen
- Department of Biology, Boston College, Chestnut Hill, MA 02467, USA
| | | | | | - Margaret M DeAngelis
- Department of Ophthalmology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Neena B Haider
- Shifa Precision, Boston, MA 02138, USA
- Department of Cell Biology, Harvard Medical School, Boston, MA 02138, USA
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Luo Y, Li G, Chen L, Hong FF. Preparation and Evaluation of Bacterial Nanocellulose/Hyaluronic Acid Composite Artificial Cornea for Application of Corneal Transplantation. Biomacromolecules 2023; 24:201-212. [PMID: 36441906 DOI: 10.1021/acs.biomac.2c01052] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The treatment for corneal damage requires donor corneal transplantation, but there is a serious scarcity of donor corneas worldwide. In this study, we aimed to design a new artificial cornea with good cytocompatibility, excellent optical properties and suture resistance, and great moisturizing properties. A new bacterial nanocellulose (BNC) membrane with anisotropic mechanical properties and high light transmission was produced in a horizontal rotary drum reactor. However, as a potential material for artificial keratoplasty, the transparency and mechanical properties of the new BNC membrane were not satisfactory. Thus, hyaluronic acid (HA) was introduced in the BNC to synthesize the BNC/HA composite membrane by using 1,4-butanediol diglycidyl ether (BDDE) as the chemical cross-linking agent. The micro-morphology, light transmittance, mechanical properties, water content, moisture retention ability, and cytocompatibility of the composite membranes were further evaluated. HA was fixed in the BNC network by the ether bond, and the composite membrane was found to have excellent light transmittance (up to 95.96%). The composite membrane showed excellent mechanical properties, for instance, its tensile strength exceeded the human normal intraocular pressure (IOP) (1.33-2.80 kPa), the maximum burst pressure was about 130 kPa, 46-97 times that of the normal IOP, and its suture force was close to that of the human amniotic membrane (0.1 N). Based on the three-dimensional network scaffold of BNC and the high water absorption characteristics of HA, the artificial cornea had high water content and high moisture retention ability. The rabbit corneal stromal cells cultured in vitro showed that the artificial cornea substitute had excellent cytocompatibility. BDDE is the most frequently used cross-linker in most HA products in the current cosmetic medicine industry owing to its long-term safety records for over 15 years. Therefore, the BNC/HA composite hydrogel cross-linked with BDDE has great potential in artificial keratoplasty or ocular surface repair.
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Affiliation(s)
- Yuhua Luo
- College of Biological Science and Medical Engineering, Donghua University, No. 2999 North Renmin Road, Shanghai201620, China.,National Advanced Functional Fiber Innovation Center, Wu Jiang, Su Zhou215200, China
| | - Geli Li
- College of Biological Science and Medical Engineering, Donghua University, No. 2999 North Renmin Road, Shanghai201620, China.,National Advanced Functional Fiber Innovation Center, Wu Jiang, Su Zhou215200, China
| | - Lin Chen
- College of Biological Science and Medical Engineering, Donghua University, No. 2999 North Renmin Road, Shanghai201620, China.,National Advanced Functional Fiber Innovation Center, Wu Jiang, Su Zhou215200, China
| | - Feng F Hong
- College of Biological Science and Medical Engineering, Donghua University, No. 2999 North Renmin Road, Shanghai201620, China.,National Advanced Functional Fiber Innovation Center, Wu Jiang, Su Zhou215200, China
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7
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Global trends and prospects in research of artificial cornea over past 20 years: a bibliometric and visualized analysis. Int Ophthalmol 2022; 43:2003-2015. [DOI: 10.1007/s10792-022-02600-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/17/2022] [Indexed: 11/28/2022]
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8
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Bachmann B, Schaub F, Cursiefen C. [Keratoprostheses: Last Hope for the Most Severe Corneal Diseases]. Klin Monbl Augenheilkd 2022; 239:1165-1179. [PMID: 35970191 DOI: 10.1055/a-1892-6142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Corneal blindness affects over 8 million adults and 1.5 million children worldwide, making it one of the top 5 causes of blindness. Depending on the recipient's corneal condition corneal transplantation may not be a viable treatment option. In such seemingly no-alternative situations, keratoprosthesis implantation can be an option in some patients. In terms of numbers, two types of keratoprostheses are currently used: 1. Keratoprostheses with biological haptics made of tooth or tibia bone. 2. The Boston type I-keratoprosthesis. Both types have optics made of PMMA. The most common complication is the formation of an optically disturbing retroprosthetic membrane behind the optic, which can usually be removed with YAG laser. Causes of blindness after keratoprosthesis implantation are glaucoma, endophthalmitis and retinal detachment. The extrusion rate of the Boston type I-keratoprosthesis seems to be higher than after keratoprosthesis implantation with biological haptic. Autoimmunological corneal diseases have increased extrusion rates and higher rates of endophthalmitis when compared to non-autoimmunological diseases. Visual outcomes after keratoprosthesis implantation are potentially very good and usually limited by extracorneal concomitant diseases. Advances in glaucoma diagnostic (OCT, implantation of intraocular pressure sensors), standard glaucoma prophylaxis by medication or surgery, modern retinal surgery and better treatment options in case of extrusion improve the prognosis of keratoprosthesis surgery. Still, the ideal technique for permanent anchoring of artifical optics in biological tissue has yet to be developed.
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Bachmann B, Schaub F, Cursiefen C. Keratoprothesen: letzte Hoffnung bei schwersten
Hornhauterkrankungen. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1488-0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
ZusammenfassungEine Vielzahl an Hornhauterkrankungen geht mit einem hohen Versagensrisiko von
Hornhauttransplantaten einher. Häufig handelt es sich um Patienten mit
beidseitig hornhautbedingter Blindheit ohne Aussicht auf Besserung. In diesen,
eigentlich aussichtslosen Situationen können Keratoprothesen häufig sehr
schnelle und erstaunliche Sehverbesserungen erzielen, die aber mit einem hohen
Risiko für schwerwiegende Komplikationen erkauft werden.
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Li Y, Xu W, Li Q, Li X, Li J, Kang L, Fang Y, Cheng S, Zhao P, Jiang S, Liu W, Yan X, Du Y, Wang L, Huang Y. 3D biomaterial P scaffolds carrying umbilical cord mesenchymal stem cells improve biointegration of keratoprosthesis. Biomed Mater 2022; 17. [PMID: 35790151 DOI: 10.1088/1748-605x/ac7e98] [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: 01/14/2022] [Accepted: 07/05/2022] [Indexed: 11/12/2022]
Abstract
Biointegration of a keratoprosthesis (KPro) is critical for the device stability and long-term retention. Biointegration of the KPro device and host tissue takes place between the surrounding corneal graft and the central optic [made by poly (methyl methacrylate) (PMMA)]. Our previous clinical results showed that auricular cartilage reinforcement is able to enhance the KPro biointegration. However, the auricular cartilage is non-renewable and difficult to acquire. In this study, we developed a novel type of biomaterial using a three-dimensional porous polyethylene glycol acrylate scaffold (3D biological P-scaffold) carrier with chondrocytes differentiated from induced human umbilical cord mesenchymal stem cells (hUC-MSCs) and tested in rabbit corneas. The results showed hUC-MSCs bear stem cell properties and coule be induced into chondrocytes, P-scaffold is beneficial to the growth and differentiation of hUC-MSCs both in vivo and in vitro. Besides, after implanting the P-scaffold into the corneal stroma, no serious immune rejection response, such as corneal ulcer or perforation were seen, suggested a good biocompatibility of P-scaffold with the corneal tissue. Moreover, after implanting P-scaffold in together with the differentiated chondrocytes into the rabbit corneal stroma, they significantly increased corneal thickness and strengthened the host cornea, and chondrocytes could stably persist inside the cornea. In summary, the 3D biological P-scaffold carrying differentiated hUC-MSCs could be the preferable material for KPro reinforcement.
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Affiliation(s)
- Yueyue Li
- Medical School of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Wenqin Xu
- Ophthalmology, General Hospital of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Qian Li
- Medical School of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Xiaoqi Li
- Medical School of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Junyang Li
- Biomedical Engineering, Tsinghua University School of Medicine, Shuangqing Road 30, Beijing, Beijing, 100084, CHINA
| | - Li Kang
- Medical School of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Yifan Fang
- Medical School of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Shuaishuai Cheng
- Biomedical Engineering, Tsinghua University School of Medicine, Shuangqing Road 30, Beijing, Beijing, 100084, CHINA
| | - Peng Zhao
- Biomedical Engineering, Tsinghua University School of Medicine, Shuangqing Road 30, Beijing, Beijing, 100084, CHINA
| | - Shumeng Jiang
- Biomedical Engineering, Tsinghua University School of Medicine, Shuangqing Road 30, Beijing, Beijing, 100084, CHINA
| | - Wei Liu
- Biomedical Engineering, Tsinghua University School of Medicine, Shuangqing Road 30, Beijing, Beijing, 100084, CHINA
| | - Xiaojun Yan
- Biomedical Engineering, Tsinghua University School of Medicine, Shuangqing Road 30, Beijing, Beijing, 100084, CHINA
| | - Yanan Du
- Tsinghua University, China-Beijing-Tsinghua University, Beijing, 100084, CHINA
| | - Liqiang Wang
- Ophthalmology, General Hospital of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
| | - Yifei Huang
- Ophthalmology, General Hospital of People's Liberation Army, Fuxing Road 28, Beijing, 100853, CHINA
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Iannetti L, Liberali M, Armentano M, Alisi L, Visioli G, Mastromarino D, Brauner E, Iannetti G. Osteo-odonto-keratoprosthesis according to Strampelli original technique: A retrospective study with up to 30 years of follow-up. Am J Ophthalmol 2022; 242:56-68. [PMID: 35618023 DOI: 10.1016/j.ajo.2022.05.015] [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: 11/08/2021] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe clinical, anatomical, and visual outcomes obtained from a long-term follow-up of 59 patients who underwent osteo-odonto-keratoprosthesis (OOKP) using the original Strampelli technique. DESIGN retrospective clinical cohort study. METHODS 82 eyes of 59 patients who underwent OOKP surgery between 1969 and 2011 were included. Patients' clinical characteristics before surgery as well as complications and further surgeries until the end of follow-up were recorded. BCVA was revised before surgery and at 1 month, 1 year and every 5 years until the 30th year of follow-up. RESULTS Mean follow-up post-OOKP was 27.4±11.2 years (2.4-52). The most frequent cause of blindness was chemical injuries (71%). OOKP integrity was maintained in 77 out of 82 eyes until the end of follow-up (94%). Excluding the cataract, acquired glaucoma was the most frequent complication with a prevalence at 10 years of 36%. Mean BCVA improved from 2.60±0.32 at presentation to 0.40±0.65 at 1 year and 1.21±1.19 logMAR at 30 years. Overall, 51% of the included eyes attained a BCVA better than 0.05 logMAR and a stabilization of BCVA was observed for the first 10 years of follow-up post-OOKP. Better BCVA outcomes were observed in the Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis (SJS/TEN) group, while glaucoma showed not to significantly affect visual acuity. CONCLUSIONS The original OOKP still represents a valid surgical choice, durable over time, for restoring vision in end-stage corneal blindness patients not eligible for a corneal transplant.
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Affiliation(s)
- Ludovico Iannetti
- From the Ophthalmology Unit (L.I.), Head and Neck Department, Policlinico Umberto I University Hospital, Sapienza University of Rome, Rome, Italy; Ophthalmology Unit (L.I., M.L.), Villa Benedetta Clinic, Rome, Italy.
| | - Marco Liberali
- Ophthalmology Unit (L.I., M.L.), Villa Benedetta Clinic, Rome, Italy; Ophthalmology Unit (M.L.), San Giovanni Addolorata Hospital, Rome, Italy
| | - Marta Armentano
- Department of Sense Organs (M.A., L.A., G.V., D.M.), Sapienza University of Rome, Rome, Italy
| | - Ludovico Alisi
- Department of Sense Organs (M.A., L.A., G.V., D.M.), Sapienza University of Rome, Rome, Italy
| | - Giacomo Visioli
- Department of Sense Organs (M.A., L.A., G.V., D.M.), Sapienza University of Rome, Rome, Italy
| | - Davide Mastromarino
- Department of Sense Organs (M.A., L.A., G.V., D.M.), Sapienza University of Rome, Rome, Italy
| | - Edoardo Brauner
- Department of Odontostomatologic and Maxillofacial Sciences (E.B., G.I.), Head and Neck Department, Sapienza University of Rome, Rome, Italy
| | - Giorgio Iannetti
- Department of Odontostomatologic and Maxillofacial Sciences (E.B., G.I.), Head and Neck Department, Sapienza University of Rome, Rome, Italy
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12
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Gerasimov MY, Ostrovskiy DS, Shatskikh AV, Borzenok SA, Malyugin BE. Labial mucosal epithelium grafting in an ex vivo human donor cornea model. Exp Eye Res 2022; 216:108931. [DOI: 10.1016/j.exer.2022.108931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/19/2021] [Accepted: 01/05/2022] [Indexed: 11/17/2022]
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13
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The Historical Development and an Overview of Contemporary Keratoprostheses. Surv Ophthalmol 2022; 67:1175-1199. [DOI: 10.1016/j.survophthal.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/07/2022] [Accepted: 01/19/2022] [Indexed: 11/24/2022]
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14
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Near-Half-Century Cardona K-Pro Retention. Cornea 2021; 41:e7. [PMID: 34935662 DOI: 10.1097/ico.0000000000002967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 11/26/2022]
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15
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Paediatric chemical burns: a clinical review. Eur J Pediatr 2021; 180:1359-1369. [PMID: 33403450 DOI: 10.1007/s00431-020-03905-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/05/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
Although they account for a small proportion of burns in paediatrics, injuries from chemicals can be just as devastating as other mechanisms of burn injury. At least 25,000 chemicals exist which can cause burns: in children, they are often caused by household chemicals via accidental exposure. The mechanism by which corrosive substances produce chemical burns highlights the importance of early and plentiful irrigation of the burn area, removal of contaminated clothes and careful clinical assessment. Surgical intervention is uncommon but often follows the principles for thermal burns. This article reviews the aetiology, incidence, clinical presentation, management, complications and prevention of chemical burns. What is Known • Chemical burns in paediatrics are often caused by accidental exposure to chemicals available at home • Differences in the pathophysiology of chemical burns reinforces the need for early irrigation What is New • New irrigation fluids show promise in adults and need further study in children • The nature of chemical cutaneous burns can make assessment of wound depth difficult. Laser Doppler Imaging (LDI) is an accurate technique that can be used clinically to determine burn depth in thermal burns and is an area of future interest in the assessment of chemical burns.
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Abstract
PURPOSE To report the first histopathological examination of an explanted KeraKlear keratoprosthesis device and surrounding host corneal tissue 1 year after transplantation. METHODS An explanted KeraKlear artificial cornea was evaluated by histopathology to assess for tissue integration and corneal remolding. RESULTS Histopathological examination revealed collagenous ingrowth between the anterior and posterior corneal stromal lamellae through the holes in the device skirt. Hematoxylin and eosin stain (H&E), periodic acid Schiff (PAS), and Masson trichrome stains demonstrated no significant inflammation, vascularization, or edema. CONCLUSIONS The KeraKlear artificial corneal device seems to be a biocompatible alternative to donor corneal tissues for visual rehabilitation for suitable patients.
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Marin-Tapia HA, Romero-Salazar L, Arteaga-Arcos JC, Rosales-Ibáñez R, Mayorga-Rojas M. Micro-mechanical properties of corneal scaffolds from two different bio-models obtained by an efficient chemical decellularization. J Mech Behav Biomed Mater 2021; 119:104510. [PMID: 33872923 DOI: 10.1016/j.jmbbm.2021.104510] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/12/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
The present study elucidates the impact of detergent-based chemical decellularization on the micro-mechanical properties of porcine and rabbit corneas for the purpose of extracellular matrix (ECM) derived scaffolds. Aiming to optimize the decellularization process, different concentrations of Sodium Dodecyl Sulfate (SDS), Triton X-100 and CHAPS detergents were assessed on their ability to decellularize corneas from both bio-models at incubation periods of 12 and 24h. We evaluated the effect of decellularization on corneal ECM Young's Modulus and various area's roughness parameters (topography features) at a microscale by using Atomic Force Microscopy (AFM). Only SDS presented adequate decellularization properties at the selected concentrations (0.2, 0.5 and 1%) and incubation periods. All topography features displayed by native corneas were preserved after SDS treatments, while no statistically significant differences were identified for the average value of Young's Modulus between the control samples and those treated with 0.2% SDS (rabbit corneas) and 0.5% SDS (porcine corneas) after 12h. In this sense, cornea decellularization procedures can be improved by simultaneously reducing SDS concentration and incubation period. AFM is a useful tool to perform biomechanical analysis of the effect of decellularization on scaffold micro-mechanics. Evaluation of the scaffold mechanical behavior at a microscale could help in understanding cell-scaffold interactions in terms of mechanotransduction, complementing macroscale techniques (e.g. tensile tests) relevant for tissue engineering quality control and decision-making.
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Affiliation(s)
- Hugo Arian Marin-Tapia
- Rheology, Nanofluids and Microfluidics Laboratory, Autonomous University of the State of Mexico, Faculty of Sciences, Campus Universitario ''El Cerrillo, Piedras Blancas", Carretera Toluca-Ixtlahuaca km 15.5, C.P. 50200 Estado de México, Mexico; Autonomous University of the State of Mexico, Faculty of Sciences, Campus Universitario ''El Cerrillo, Piedras Blancas", Carretera Toluca-Ixtlahuaca km 15.5, C.P. 50200 Estado de México, Mexico.
| | - Lorena Romero-Salazar
- Nanothermodynamics and Complex Systems Laboratory, Autonomous University of the State of Mexico, Faculty of Sciences, Campus Universitario ''El Cerrillo, Piedras Blancas", Carretera Toluca-Ixtlahuaca km 15.5, C.P. 50200 Estado de México, Mexico.
| | - Juan Carlos Arteaga-Arcos
- Micromechanics Laboratory, Autonomous University of the State of Mexico, Faculty of Sciences, Instituto Literario, No. 100 Ote., C.P, 50000, Toluca, State of Mexico, Mexico.
| | - Raúl Rosales-Ibáñez
- Tissue Engineering and Translational Medicine Laboratory, Faculty of Higher Studies (FES) Iztacala, National Autonomous University of Mexico, Tlalnepantla, 54090, Mexico City, Mexico.
| | - Miguel Mayorga-Rojas
- Rheology, Nanofluids and Microfluidics Laboratory, Autonomous University of the State of Mexico, Faculty of Sciences, Campus Universitario ''El Cerrillo, Piedras Blancas", Carretera Toluca-Ixtlahuaca km 15.5, C.P. 50200 Estado de México, Mexico.
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Significance of Crosslinking Approaches in the Development of Next Generation Hydrogels for Corneal Tissue Engineering. Pharmaceutics 2021; 13:pharmaceutics13030319. [PMID: 33671011 PMCID: PMC7997321 DOI: 10.3390/pharmaceutics13030319] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 02/07/2023] Open
Abstract
Medical conditions such as trachoma, keratoconus and Fuchs endothelial dystrophy can damage the cornea, leading to visual deterioration and blindness and necessitating a cornea transplant. Due to the shortage of donor corneas, hydrogels have been investigated as potential corneal replacements. A key factor that influences the physical and biochemical properties of these hydrogels is how they are crosslinked. In this paper, an overview is provided of different crosslinking techniques and crosslinking chemical additives that have been applied to hydrogels for the purposes of corneal tissue engineering, drug delivery or corneal repair. Factors that influence the success of a crosslinker are considered that include material composition, dosage, fabrication method, immunogenicity and toxicity. Different crosslinking techniques that have been used to develop injectable hydrogels for corneal regeneration are summarized. The limitations and future prospects of crosslinking strategies for use in corneal tissue engineering are discussed. It is demonstrated that the choice of crosslinking technique has a significant influence on the biocompatibility, mechanical properties and chemical structure of hydrogels that may be suitable for corneal tissue engineering and regenerative applications.
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Deng SX, Dos Santos A, Gee S. Therapeutic Potential of Extracellular Vesicles for the Treatment of Corneal Injuries and Scars. Transl Vis Sci Technol 2020; 9:1. [PMID: 33200043 PMCID: PMC7645240 DOI: 10.1167/tvst.9.12.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Infection, trauma, and chemical exposure of the ocular surface can severely damage the cornea, resulting in visually significant stromal scars. Current medical treatments are ineffective in mitigating corneal scarring, and corneal transplantation is the only therapy able to restore vision in these eyes. However, because of a severe shortage of corneal tissues, risks of blinding complications associated with corneal transplants, and a higher rate of graft failure in these eyes, an effective and deliverable alternative therapy for the prevention and treatment of corneal scarring remains a significant unmet medical need globally. In recent years, the therapeutic potential of extracellular vesicles (EVs) secreted by cells to mediate cell-cell communication has been a topic of increasing interest. EVs derived from mesenchymal stem cells, in particular human corneal stromal stem cells, have antifibrotic, anti-inflammatory, and regenerative effects in injured corneas. The exact mechanism of action of these functional EVs are largely unknown. Therapeutic development of EVs is at an early stage and warrants further preclinical studies.
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Affiliation(s)
- Sophie X. Deng
- Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
| | - Aurelie Dos Santos
- Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
| | - Serina Gee
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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20
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Rahhal-Ortuño M, Fernández-Santodomingo AS, Villena-Alvarado C, Marín-Payá E, Aguilar-González M, García-Delpech S. Cyclosporine 0.1% (Ikervis ®) as a corticoid-sparing agent in Lyell syndrome with KeraKlear ® keratoprosthesis. Taiwan J Ophthalmol 2020; 10:309-311. [PMID: 33437608 PMCID: PMC7787086 DOI: 10.4103/tjo.tjo_1_20] [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: 08/09/2019] [Accepted: 12/24/2019] [Indexed: 11/12/2022] Open
Abstract
Cyclosporine 0.1% was used in a patient with Lyell syndrome, which had undergone a KeraKlear® keratoprosthesis implant due to the severe ocular involvement to avoid overuse of corticoid agents. To the best of our knowledge, this is the first reported case of cyclosporine 0.1% eye drops to use in Lyell syndrome previously treated with keratoprosthesis implant.
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Affiliation(s)
- Miriam Rahhal-Ortuño
- Department of Ophthalmology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | | | | | - Emma Marín-Payá
- Department of Ophthalmology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
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21
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Touma S, Harissi-Dagher M. Outcomes and complications of Boston keratoprosthesis type I implantation in unilateral versus bilateral corneal blindness. Can J Ophthalmol 2020; 56:130-136. [PMID: 33002416 DOI: 10.1016/j.jcjo.2020.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/08/2020] [Accepted: 08/29/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare the outcomes of Boston keratoprosthesis (KPro) type I implantation between patients who are legally blind versus sighted in the contralateral eye. DESIGN Single centre retrospective comparative case series. PARTICIPANTS Patients who underwent Boston KPro type I implantation between 2008 and 2017. METHODS Single-center retrospective comparative case series. Patients were divided into 2 groups based on the preoperative best-corrected visual acuity (BCVA) in the contralateral eye: group I (>20/200) and group II (20/200). MAIN OUTCOME MEASURES Postoperative BCVA, device retention, and complications. RESULTS Group I (56 eyes) and group II (53 eyes) had similar demographics, median preoperative BCVA (hand movements) in the operated eye, and median duration of postoperative follow-up (76.92 vs 85.6 months, respectively). Final postoperative BCVA of the operated eye was statistically better in group I compared with group II (20/400 and hand movements, respectively, p = 0.03). There was no statistical significance in device retention mean survival time. The most common complication in both groups was retroprosthetic membrane. Cystoid macular edema occurred more frequently in group I (p = 0.004), whereas retinal detachment was more common in group II (p = 0.052). CONCLUSIONS Most patients who underwent Boston KPro type I implantation experienced an improvement in their vision, with final BCVA being superior in the unilateral blind group. Despite similar complication rates and device retention, there are additional socioeconomic factors that need to be considered in sighted individuals. Because the prognosis is tied to the underlying etiology, it is important to recognize that some diagnoses may influence a better outcome.
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Affiliation(s)
- Samir Touma
- Faculty of Medicine, McGill University, Montreal, Que..
| | - Mona Harissi-Dagher
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal, Montreal, Que
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22
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Griffith M, Poudel BK, Malhotra K, Akla N, González-Andrades M, Courtman D, Hu V, Alarcon EI. Biosynthetic alternatives for corneal transplant surgery. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1754798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- May Griffith
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Bijay Kumar Poudel
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Kamal Malhotra
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Naoufal Akla
- Department of Ophthalmology, University of Montreal and Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
| | - Miguel González-Andrades
- Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - David Courtman
- Department of Medicine, University of Ottawa, and Scientist, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Victor Hu
- London School of Hygiene and Tropical Medicine, International Center for Eye Health, London, UK
| | - Emilio I. Alarcon
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Zhu BB, Zhou J, Zheng J, Zhang Y, Wan T, Huang XD, Lin L, Jin XM. Corneal graft melting: a systematic review. Int J Ophthalmol 2020; 13:493-502. [PMID: 32309189 DOI: 10.18240/ijo.2020.03.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/20/2019] [Indexed: 12/22/2022] Open
Abstract
Corneal graft melting is a severe complication of keratoplasty. This review is to summarize the incidence, the pathogenesis, the risk factors, the prognosis and the prevention of corneal graft melting after keratoplasty. We systematically searched PubMed, Web of Science and WanFang database to retrieve potentially eligible articles about relevant clinical reports and animal experiments. We read the full texts to identify eligible articles. The selection of studies and data extraction were performed independently by two reviewers. In conclusion, the pathogenesis of corneal graft melting is complicated, and many risk factors are closely related to corneal graft melting. Analysis of pathogenesis and risk factors of corneal graft melting can facilitate the development of targeted therapies to better guide clinical practice.
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Affiliation(s)
- Bin-Bin Zhu
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Jie Zhou
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Jiao Zheng
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yue Zhang
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Ting Wan
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Xiao-Dan Huang
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Lin Lin
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Xiu-Ming Jin
- Eye Center, the Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
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24
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Bandeira F, Goh TW, Setiawan M, Yam GHF, Mehta JS. Cellular therapy of corneal epithelial defect by adipose mesenchymal stem cell-derived epithelial progenitors. Stem Cell Res Ther 2020; 11:14. [PMID: 31900226 PMCID: PMC6942321 DOI: 10.1186/s13287-019-1533-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/29/2019] [Accepted: 12/17/2019] [Indexed: 12/13/2022] Open
Abstract
Background Persistent epithelial defects (PED), associated with limbal stem cell deficiency (LSCD), require ocular surface reconstruction with a stable corneal epithelium (CE). This study investigated CE reformation using human adipose mesenchymal stem cells (ADSC), which derived epithelial progenitors via mesenchymal-epithelial transition (MET). Methods STEMPRO human ADSC were cultured with specific inhibitors antagonizing glycogen synthase kinase-3 and transforming growth factor-β signaling, followed by culture under a defined progenitor cell targeted-epithelial differentiation condition to generate epithelial-like cells (MET-Epi), which were characterized for cell viability, mesenchymal, and epithelial phenotypes using immunofluorescence and flow cytometry. Tissue-engineered (TE) MET-Epi cells on fibrin gel were transplanted to corneal surface of the rat LSCD model caused by alkali injury. Epithelial healing, corneal edema, and haze grading, CE formation were assessed by fluorescein staining, slit lamp bio-microscopy, anterior segment optical coherence tomography, and immunohistochemistry. Results CD73high/CD90high/CD105high/CD166high/CD14negative/CD31negative human ADSC underwent MET, giving viable epithelial-like progenitors expressing δNp63, CDH1 (E-cadherin), epidermal growth factor receptor, integrin-β4, and cytokeratin (CK)-5, 9. Under defined epithelial differentiation culture, these progenitors generated MET-Epi cells expressing cell junction proteins ZO1 and occludin. When transplanted onto rat corneal surface with LSCD-induced PED, TE-MET-Epi achieved more efficient epithelial healing, suppressed corneal edema, and opacities, when compared to corneas without treatment or transplanted with TE-ADSC. CE markers (CK3, 12, and CDH1) were expressed on TE-MET-Epi-transplanted corneas but not in other control groups. Conclusion Human ADSC-derived epithelial-like cells, via MET, recovered the CE from PED associated with LSCD. ADSC can be a viable adult stem cell source for potential autologous epithelial cell-based therapy for corneal surface disorders.
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Affiliation(s)
- Francisco Bandeira
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 20 College Road, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Federal University of São Paulo, Sao Paulo, Brazil
| | - Tze-Wei Goh
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 20 College Road, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Melina Setiawan
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 20 College Road, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Gary Hin-Fai Yam
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 20 College Road, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore. .,Eye-Academic Clinical Program, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore, Singapore.
| | - Jodhbir S Mehta
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 20 College Road, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore. .,Eye-Academic Clinical Program, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore, Singapore. .,Singapore National Eye Centre, Singapore, Singapore. .,School of Material Science and Engineering, Nanyang Technological University, Singapore, Singapore.
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Kilic Bektas C, Hasirci V. Cell loaded 3D bioprinted GelMA hydrogels for corneal stroma engineering. Biomater Sci 2020; 8:438-449. [DOI: 10.1039/c9bm01236b] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Tissue engineering aims to replace missing or damaged tissues and restore their functions.
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Affiliation(s)
- Cemile Kilic Bektas
- Department of Biological Sciences
- Middle East Technical University (METU)
- Ankara
- Turkey
- Department of Biotechnology
| | - Vasif Hasirci
- Department of Biological Sciences
- Middle East Technical University (METU)
- Ankara
- Turkey
- Department of Biotechnology
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26
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Malyugin BE, Borzenok SA, Kovshun EV, Golovin AV, Shatskikh AV, Enkina AV, Ostrovsky DS, Belodedova AV, Jones MM. [Morphological changes in rabbit cornea after implantation of a new keratoprosthesis supporting plate]. Vestn Oftalmol 2020; 136:77-86. [PMID: 33056967 DOI: 10.17116/oftalma202013605177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To evaluate biocompatibility of the new keratoprosthesis supporting plates (KSP) in rabbits in vivo. MATERIAL AND METHODS The study included 15 chinchilla rabbits. In the first group (5 rabbit eyes) KSP made of hydrophobic acryl with square penetrating holes of 220×220 micron (model 1) were inserted into rabbits' corneas. In the second group (5 eyes), KSP made of hydrophobic acryl were used that had trapezoidal fenestrations with size (from 170×130 micron to 180×70 microns) gradually changing from periphery to the center of KSP (model 2). The control group rabbits (5 eyes) had 1/2 of Fyodorov-Zuev KSP made of titanium implanted. All animals were observed for up to 3 months with biomicroscopy and optical coherence tomography of the anterior segment. The animals were then euthanized and had their corneo-scleral discs excised and then examined with optical microscopy and scanning electron microscopy (SEM). RESULTS After 3 months, there was only one case of KSP protrusion in the first group. In the second group, thinning of the corneal layers above the central part of KSP occurred in one case. The presence of polymer KSP (of both models) in the corneal stroma was found not to cause formation of rough fibrotic tissue. At the same time, adhered cellular and fibrous elements were discovered on the surface and inside the holes of the polymer KSP, while on the surface of the titanium plate cellular elements were absent. CONCLUSION Supporting plates made of hydrophobic acrylic material can potentially serve as a foundation for the new keratoprosthesis design.
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Affiliation(s)
- B E Malyugin
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - S A Borzenok
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - E V Kovshun
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A V Golovin
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A V Shatskikh
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A V Enkina
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - D S Ostrovsky
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - A V Belodedova
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - M M Jones
- Reper ltd., Nizhniy Novgorod, Russia
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Kilic Bektas C, Hasirci V. Cell Loaded GelMA:HEMA IPN hydrogels for corneal stroma engineering. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 31:2. [PMID: 31811387 DOI: 10.1007/s10856-019-6345-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
Stroma is the main refractive element of the cornea and damage to it is one of the main causes of blindness. In this study, cell loaded hydrogels of methacrylated gelatin (GelMA) and poly(2-hydroxyethyl methacrylate) (pHEMA) (8:2) interpenetrating network (IPN) hydrogels were prepared as the corneal stroma substitute and tested in situ and in vitro. Compressive modulus of the GelMA hydrogels was significantly enhanced with the addition of pHEMA in the structure (6.53 vs 155.49 kPa, respectively). More than 90% of the stromal keratocytes were viable in the GelMA and GelMA-HEMA hydrogels as calculated by Live-Dead Assay and NIH Image-J program. Cells synthesized representative collagens and proteoglycans in the hydrogels indicating that they preserved their keratocyte functions. Transparency of the cell loaded GelMA-HEMA hydrogels was increased significantly up to 90% at 700 nm during three weeks of incubation and was comparable with the transparency of native cornea. Cell loaded GelMA-HEMA corneal stroma model is novel and reported for the first time in the literature in terms of introduction of cells during the preparation phase of the hydrogels. The appropriate mechanical strength and high transparency of the cell loaded constructs indicates a viable alternative to the current devices used in the treatment of corneal blindness.
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Affiliation(s)
- Cemile Kilic Bektas
- Department of Biological Sciences, Middle East Technical University (METU), Ankara, Turkey
- Department of Biotechnology, METU, Ankara, Turkey
- BIOMATEN, METU Center of Excellence in Biomaterials and Tissue Engineering, Ankara, Turkey
| | - Vasif Hasirci
- Department of Biological Sciences, Middle East Technical University (METU), Ankara, Turkey.
- Department of Biotechnology, METU, Ankara, Turkey.
- BIOMATEN, METU Center of Excellence in Biomaterials and Tissue Engineering, Ankara, Turkey.
- Department of Medical Engineering, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
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Li Z, Goh TW, Yam GHF, Thompson BC, Hu H, Setiawan M, Sun W, Riau AK, Tan DT, Khor KA, Mehta JS. A sintered graphene/titania material as a synthetic keratoprosthesis skirt for end-stage corneal disorders. Acta Biomater 2019; 94:585-596. [PMID: 31129362 DOI: 10.1016/j.actbio.2019.05.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 01/21/2023]
Abstract
An artificial cornea or keratoprosthesis requires high mechanical strength, good biocompatibility, and sufficient wear and corrosion resistance to withstand the hostile environment. We report a reduced graphene oxide-reinforced titania-based composite for this application. Graphene oxide nanoparticles (GO) and liquid crystalline graphene oxide (LCGO) were the graphene precursors and mixed with titanium dioxide (TiO2) powder. The composites reinforced with reduced GO or LCGO were produced through spark plasma sintering (SPS). The mechanical properties (Young's modulus and hardness), wear behaviour and corrosion resistance were studied using nanoindentation, anoidic polarization, long-term corrosion assay in artificial tear fluid and tribology assay in corroboration with atomic force microscopy and scanning electron microscopy. Biocompatibility was assessed by human corneal stromal cell attachment, survival and proliferation, and DNA damages. Sintered composites were implanted into rabbit corneas to assess for in vivo stability and host tissue responses. We showed that reduced graphene/TiO2 hybrids were safe and biocompatible. In particular, the 1% reduced LCGO/TiO2 (1rLCGO/TiO2) composite was mechanically strong, chemically stable, and showed better wear and corrosion resistance than pure titania and other combinations of graphene-reinforced titania. Hence the 1rLCGO/ TiO2 bioceramics can be a potential skirt biomaterial for keratoprosthesis to treat end-stage corneal blindness. STATEMENT OF SIGNIFICANCE: The osteo-odonto-keratoprosthesis (OOKP) is an artificial cornea procedure used to restore vision in end-stage corneal diseases, however it is contraindicated in young subjects, patients with advanced imflammatory diseases and posterior segment complications. Hence, there is a need of an improved keratoprosthesisskirt material with high mechanical and chemical stability, wear resistance and tissue integration ability. Our study characterized a reduced graphene oxide-reinforced titania-based biomaterial, which demonstrated strong mechanical strength, wear and corrosion resistance, and was safe and biocompatible to human corneal stromal cells. In vivo implantation to rabbit corneas did not cause any immune and inflammation outcomes. In conclusion, this invention is a potential keratoprosthesis skirt biomaterial to withstand the hostile environment in treating end-stage corneal blindness.
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Rahmani S, Kanavi MR, Javadi MA, Langroudi MM, Aski SA. Histopathologic Evaluation of Polymer Supports for Pintucci-type Keratoprostheses: An Animal Study. J Ophthalmic Vis Res 2019; 14:243-250. [PMID: 31660102 PMCID: PMC6815345 DOI: 10.18502/jovr.v14i3.4779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/28/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose To report histopathological findings for different types of polymers proposed as support for a Pintucci-type keratoprosthesis. Methods Six polymers, including three types of polyesters (#1-3), one type of polytetrafluoroethylene (PTFE, #4), polyethylene (#5), and expanded polytetrafluoroethylene (ePTFE, #6) were evaluated. Four samples of each material were placed under the orbicularis oculi muscles of 12 rabbits. After five weeks, the samples were removed and evaluated histopathologically. Fibrovascular tissue ingrowths were investigated in terms of tissue penetration depth into the materials (graded as none, mild, moderate, and intense) and fibrovascular ingrowth area at the ultimate level of tissue penetrance. ImageJ software was used to calculate fibrovascular tissue area between the material fibers, and the mean area values were compared between the materials. Results Polyester materials #1 and #3 demonstrated intense fibrovascular tissue penetration with a large fibrovascular ingrowth area; no overt tissue ingrowth was observed into material #6. The mean area of penetrated fibrovascular tissues was significantly different between materials (P < 0.001). Materials #2, #4, and #5 showed moderate fibrovascular tissue ingrowth and the area of presented fibrovascular tissue at the paracentral parts of material #4 was significantly smaller than that of materials #1 (P = 0.02) and #3 (P = 0.01). Conclusion Two polyester materials that had relatively large pore sizes demonstrated a deep and large area of fibrovascular ingrowth. Given that material #3 is thicker and more consistent than material #1, the former can be used as the appropriate material for supporting the Pintucci-type keratoprosthesis.
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Affiliation(s)
- Saeed Rahmani
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mozhgan Rezaei Kanavi
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sasha Afsar Aski
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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de la Paz MF, Salvador-Culla B, Charoenrook V, Temprano J, Álvarez de Toledo J, Grabner G, Michael R, Barraquer RI. Osteo-odonto-, Tibial bone and Boston keratoprosthesis in clinically comparable cases of chemical injury and autoimmune disease. Ocul Surf 2019; 17:476-483. [DOI: 10.1016/j.jtos.2019.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/05/2019] [Accepted: 04/09/2019] [Indexed: 01/16/2023]
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Corneal Stromal Transplantation With Human-derived Acellular Dermal Matrix for Pellucid Marginal Corneal Degeneration: A Nonrandomized Clinical Trial. Transplantation 2019; 103:e172-e179. [DOI: 10.1097/tp.0000000000002681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Zhang K, Ren XX, Li P, Pang KP, Wang H. Construction of a full-thickness human corneal substitute from anterior acellular porcine corneal matrix and human corneal cells. Int J Ophthalmol 2019; 12:351-362. [PMID: 30918800 DOI: 10.18240/ijo.2019.03.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/28/2018] [Indexed: 12/13/2022] Open
Abstract
AIM To construct functional human full-thickness corneal replacements. METHODS Acellular porcine corneal matrix (APCM) was developed from porcine cornea by decellulariztion. The biomechanical properties of anterior-APCM (AAPCM) and posterior-APCM (PAPCM) were checked using uniaxial tensile testing. Human corneal cells were obtained by cell culture. Suspending ring was designed by deformation of an acupuncture needle. MTT cytotoxicity assay was used to check the cytotoxicity of suspending ring soaking solutions. A new three-dimensional organ culture system was established by combination of suspending ring, 48-well plate and medium together. A human full-thickness corneal substitute was constructed from human corneal cells with AAPCM in an organ coculture system. Biochemical marker expression of the construct was measured by immunofluorescent staining and morphological structures were observed using scanning electron microscopy. Pump function and biophysical properties were examined by penetrating keratoplasty and follow-up clinical observations. RESULTS There were no cells in the AAPCM or PAPCM, whereas collagen fibers, Bowman's membrane, and Descemet's membrane were retained. The biomechanical property of AAPCM was better than PAPCM. Human corneal cells grew better on the AAPCM than on the PAPCM. There was no cytotoxicity for the suspending ring soaking solutions. For the constructed full-depth human corneal replacements keratocytes scattered uniformly throughout the AAPCM and expressed vimentin. The epithelial layer was located on the surface of Bowman's membrane and composed of three or four layers of epithelial cells expressing cytokeratin 3. One layer of endothelial cells covered the stromal surface of AAPCM, expressed Na+/K+ATPase and formed the endothelial layer. The construct was similar to normal human corneas, with many microvilli on the epithelial cell surface, stromal cells with a long shuttle shape, and zonula occludens on the interface of endothelial cells. The construct withstood surgical procedures during penetrating keratoplasty. The corneal transparency increased gradually and was almost completely restored 7d after surgery. CONCLUSION AAPCM is an ideal scaffold for constructing full-thickness corneal replacement, and functional human full-thickness corneal replacements are successfully constructed using AAPCM and human corneal cells.
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Affiliation(s)
- Kai Zhang
- Department of Ophthalmology, Shandong Provincial Western Hospital, Jinan 250022, Shandong Province, China.,Shandong Institute of Otolaryngology, Jinan 250022, Shandong Province, China
| | - Xiao-Xiao Ren
- Department of Ophthalmology, Shandong Provincial Western Hospital, Jinan 250022, Shandong Province, China
| | - Ping Li
- Department of Ophthalmology, Shandong Provincial Western Hospital, Jinan 250022, Shandong Province, China
| | - Kun-Peng Pang
- Department of Ophthalmology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
| | - Hong Wang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
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Rahmani S, Bagheri A, Karimian F, Javadi MA, Delfazayebaher S. Vision Rehabilitation with a Native Pintucci-type Keratoprosthesis. J Ophthalmic Vis Res 2019; 14:101-104. [PMID: 30820295 PMCID: PMC6388536 DOI: 10.4103/jovr.jovr_52_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To report visual rehabilitation with a native Pintucci keratoprosthesis (KPro) after a severe ocular surface chemical burn in a male patient. Case Report A 41-year-old man experienced a bilateral severe chemical burn 5 years previously. Earlier penetrating keratoplasty and keratolimbal allografts were unsuccessful in both eyes, and neither of the eyes had vision better than light perception. Both corneas were opaque and conjunctivalized. Because of severe dry eye and total limbal stem cell deficiency, the left eye was considered for a Pintucci-type KPro. In the first stage, the ocular surface was reconstructed with an oral mucus membrane graft, and a KPro was placed under the skin and orbicularis oculi muscle. Three months later, the KPro was removed and implanted in the left eye. During seven months after the KPro implantation, the anatomical position was acceptable, and his best corrected visual acuity was 2/10. Conclusion Bearing in mind the successful results of the native Pintucci KPro in this case of severe acid burn, using this type of keratoprosthesis in patients with total limbal stem cell deficiency and severe dry eye is recommended.
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Affiliation(s)
- Saeed Rahmani
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Bagheri
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Karimian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siamak Delfazayebaher
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abstract
PURPOSE Severe corneal disease contributes significantly to the global burden of blindness. Corneal allograft surgery remains the most commonly used treatment, but does not succeed long term in every patient, and the odds of success fall with each repeated graft. The Boston keratoprosthesis type I has emerged as an alternative to repeat corneal allograft. However, cost limits its use in resource-poor settings, where most corneal blind individuals reside. METHODS All aspects of the Boston keratoprosthesis design process were examined to determine areas of potential modification and simplification, with dual goals to reduce cost and improve the cosmetic appearance of the device in situ. RESULTS Minor modifications in component design simplified keratoprosthesis manufacturing. Proportional machinist time could be further reduced by adopting a single axial length for aphakic eyes, and a single back plate diameter. The cosmetic appearance was improved by changing the shape of the back plate holes from round to radial, with a petaloid appearance, and by anodization of back plate titanium to impute a more natural color. CONCLUSIONS We have developed a modified Boston keratoprosthesis type I, which we call the "Lucia." The Lucia retains the 2 piece design and ease of assembly of the predicate device, but would allow for manufacturing at a reduced cost. Its appearance should prove more acceptable to implanted patients. Successful keratoprosthesis outcomes require daily medications for the life of the patient and rigorous, frequent, postoperative care. Effective implementation of the device in resource-poor settings will require further innovations in eye care delivery.
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Drevon-Gaillot E. Ocular Medical Devices: Histologic Technique and Histopathologic Evaluation of the Biocompatibility and Performance. Toxicol Pathol 2018; 47:418-425. [DOI: 10.1177/0192623318813533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ocular medical devices (MDs) represent a very wide and promising field of human ophthalmology. In preclinical studies evaluating the safety and/or performance of these ocular MDs, the choice of histologic technique and the focus of the histopathologic evaluation method should take into consideration the following aspects: the specific guidelines possibly associated with the MD or combination product, the ocular compartment in contact with the MD and its specificities, and last the nature of the biomaterial used in the MD. Following a brief overview of animal models, this short review will present the different types of ocular MDs and will present the specificities of the histologic technique and the histopathologic evaluation related to ocular MDs.
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Li L, Jiang H, Wang LQ, Huang YF. Experimental study on the biocompatibility of keratoprosthesis with improved titanium implant. Int J Ophthalmol 2018; 11:1741-1745. [PMID: 30450302 DOI: 10.18240/ijo.2018.11.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 09/27/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate whether hydroxyapatite (HAp) coating can improve keratoprosthesis (KPro) implant biointegration, ultimately to decrease the risk of implant-associated complications. METHODS The modified titanium implant was designed and prepared for artificial cornea. The titanium implant was treated with sandblasting and hydroxyapatite coating by acid-base two-step method. Surface was analyzed by scanning electron microscopy (SEM), KPro implants coated with HAp and KPro implant sandblasted were implanted in rabbits. Tissue adhesion to the implant was assessed and compared to an unmodified implant by histopathology (HE), transmission electron microscopy (TEM) and SEM. RESULTS SEM demonstrated successful deposition of HAp on titanium implant sandblasted (HA/SB-Ti). The hydroxyapatite coatings caused enhancement of keratocyte proliferation compared with unmodified implant surfaces. HAp coating significantly increased adhesion forces. HAp coating of implants reduced the inflammatory response around the KPro implants in vivo. CONCLUSION HAp-coated surfaces for use in titanium KPro implant greatly enhanced adherence of the titanium KPro implant in the rabbit cornea.
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Affiliation(s)
- Li Li
- Department of Ophthalmology, the 88th Hospital of Chinese People's Liberation Army, Taian 271000, Shandong Province, China
| | - Hua Jiang
- Department of Ophthalmology, Jinan Military General Hospital, Jinan 250031, Shandong Province, China
| | - Li-Qiang Wang
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yi-Fei Huang
- Department of Ophthalmology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Bhamra TS, Tighe BJ, Li J. High modulus hydrogels for ophthalmic and related biomedical applications. J Biomed Mater Res B Appl Biomater 2018; 107:1645-1653. [PMID: 30296363 DOI: 10.1002/jbm.b.34257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/07/2018] [Accepted: 08/31/2018] [Indexed: 02/06/2023]
Abstract
This paper presents three families of semi-interpenetrating polymer network (SIPN) hydrogels based on an ester-based polyurethane (EBPU) and hydrophilic monomers: N,N-dimethylacrylamide (NNDMA), N-vinyl pyrrolidone (NVP) and acryloylmorpholine (AMO) as potential materials for keratoprosthesis, orthokeratology and mini-scleral lens application. Hydrogels sheets were synthesized via free-radical polymerization with methods developed in-house. SIPN hydrogels were characterized for their equilibrium water content, mechanical and surface properties. Three families of optically clear SIPN-based hydrogels have been synthesized in the presence of water with >10% of composition attributable to EBPU. Water contents of SIPN materials ranged from 30% to 70%. SIPNs with ≤15% EBPU of total composition showed little influence to mechanical properties, whereas >15% EBPU contributed significantly to an increase in material stiffness. In the hydrated state, SIPNs with ≤15% EBPU of total composition show little difference in polar component (γp ) of surface free energy, whereas for >15% EBPU there is a decrease in γp . The EBPU SIPN hydrogels display complementary material properties for keratoprosthesis, orthokeratology, and mini-scleral applications. © 2018 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1645-1653, 2019.
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Affiliation(s)
- Tarnveer S Bhamra
- Biomaterials Research Unit, Chemical Engineering and Applied Chemistry, Aston University, Aston Triangle, Birmingham, B4 7ET, UK
| | - Brian J Tighe
- Biomaterials Research Unit, Chemical Engineering and Applied Chemistry, Aston University, Aston Triangle, Birmingham, B4 7ET, UK
| | - Jiffan Li
- Biomaterials Research Unit, Chemical Engineering and Applied Chemistry, Aston University, Aston Triangle, Birmingham, B4 7ET, UK
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Pelletier JS, Barone SB, Capriotii JA. Keratoprosthesis prophylaxis: is it time for a paradigm shift? Clin Ophthalmol 2018; 12:1785-1788. [PMID: 30254417 PMCID: PMC6140746 DOI: 10.2147/opth.s178622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Boston Type I Keratoprosthesis has been improving in both design and safety since its inception. Due to particular features inherent in the Boston Type I Keratoprosthesis eye and certain aspects of the ocular surface, special attention is required to maintain these implanted devices. There is currently a prominent role for keratoprosthesis prophylaxis; it is designed to prevent infectious complications like keratitis and endophthalmitis. This standard-of-care therapy has anecdotally been shown to improve outcomes; however, it has not been examined in the setting of controlled clinical trials. Moreover, concerns remain with the chronic utilization of topical antibiotics in that they may engender antibiotic resistance and select for opportunistic populations to establish a foothold on the ocular surface. We believe and introduce the idea that there is merit in exploring other compounds besides antibiotics for prophylaxis such as antiseptics like povidone-iodine. Specifically developed formulations of povidone-iodine may prove useful in both improving keratoprosthesis safety and simultaneously mitigating concerns regarding antibiotic resistance.
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Affiliation(s)
- J S Pelletier
- Department of Ophthalmology, Veloce BioPharma LLC, Fort Lauderdale, FL, USA, .,Department of Ophthalmology, Plessen Ophthalmology Consultants, Christiansted, VI, USA, .,Department of Ophthalmology, Ocean Ophthalmology Group, Miami, FL, USA,
| | - S B Barone
- Department of Ophthalmology, Veloce BioPharma LLC, Fort Lauderdale, FL, USA,
| | - J A Capriotii
- Department of Ophthalmology, Veloce BioPharma LLC, Fort Lauderdale, FL, USA, .,Department of Ophthalmology, Plessen Ophthalmology Consultants, Christiansted, VI, USA,
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Li Z, Yam GHF, Thompson BC, Setiawan M, Goh GTW, Tan D, Mehta JS, Khor KA. Optimization of spark plasma sintered titania for potential application as a keratoprosthesis skirt. J Biomed Mater Res A 2017; 105:3502-3513. [PMID: 28869708 DOI: 10.1002/jbm.a.36198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 08/02/2017] [Accepted: 08/30/2017] [Indexed: 11/11/2022]
Abstract
The manufacture of mechanically strong and biocompatible titania (TiO2 ) materials is of vital importance for their application as corneal implant skirts. This study was aimed at optimizing the selection of raw powder and sintering conditions for TiO2 ceramics. TiO2 compacts were synthesized from five raw powders, denoted as Altair, Inframat, Alfa, Materion, and Amperit, respectively, by spark plasma sintering using different sintering parameters. The XRD and Raman results confirmed that the anatase TiO2 phase in the Inframat powder had converted completely to rutile TiO2 phase after sintering at 900°C and above. The nanoindentation results indicated that among the five types of TiO2 samples sintered at 1100°C, the Inframat pellets possessed the highest Young's modulus and hardness. Additionally, when Materion samples were employed to study the effects of SPS parameters, a higher sintering temperature in the range of 1100-1300°C decreased the mechanical properties of sintered pellets probably due to the generation of more structural defects. Culture of human corneal stromal fibroblasts on the sintered sample surfaces showed that comparably high cell viability and proliferation were observed on all TiO2 samples except Amperit compared to positive control. Furthermore, cells cultured on Inframat TiO2 sintered in the temperature range of 900-1300°C exhibited viability and formation of focal adhesion complex similar to those on control, and those prepared at 1100°C had significantly higher cell proliferation indices than control. In conclusion, Inframat TiO2 consolidated at 1100°C by SPS was the best formulation for the preparation of mechanically strong and biocompatible Keratoprosthesis skirt. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3502-3513, 2017.
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Affiliation(s)
- Zhong Li
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Gary Hin-Fai Yam
- Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore.,Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Brianna C Thompson
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Melina Setiawan
- Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | | | - Donald Tan
- Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore.,Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.,Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Jodhbir S Mehta
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore.,Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore.,Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.,Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Khiam Aik Khor
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
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Fung SSM, Jabbour S, Harissi-Dagher M, Tan RRG, Hamel P, Baig K, Ali A. Visual Outcomes and Complications of Type I Boston Keratoprosthesis in Children: A Retrospective Multicenter Study and Literature Review. Ophthalmology 2017; 125:153-160. [PMID: 28807636 DOI: 10.1016/j.ophtha.2017.07.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To report outcomes and complications of Boston type 1 keratoprosthesis (KPro) implantation in children. DESIGN Retrospective, multicenter case series. PARTICIPANTS All children 16 years of age or younger who underwent KPro surgery at 3 ophthalmology centers in Canada between January 2010 and November 2014. METHODS Records of patients having undergone KPro implantation were reviewed. Data on preoperative characteristics, surgical procedure(s) performed, and postoperative outcomes were collected and analyzed. MAIN OUTCOME MEASURES Intraoperative and postoperative complications, device retention, and best-corrected visual acuity (BCVA). RESULTS The KPro was implanted in 11 eyes of 11 patients 0.9 to 15.5 years of age, with 6 being primary corneal procedures. Best-corrected visual acuity recorded before surgery ranged from 20/600 to light perception (LP), and vision in 2 eyes was fix and follow. All patients had been diagnosed with glaucoma and 6 eyes had glaucoma drainage devices (GDDs) inserted before KPro implantation. At last follow-up (mean, 41.8 months; range, 6.5-85.0 months), 2 eyes retained BCVA of 20/400 or better, whereas 5 eyes lost LP. Postoperative complications included retroprosthetic membrane (9 eyes), corneal melt (5 eyes), infectious keratitis (3 eyes), endophthalmitis (3 eyes), GDD erosion (2 eyes), and retinal detachment (5 eyes). The initial KPro was retained in 4 eyes (36.4%). CONCLUSIONS Boston type 1 keratoprosthesis implantation in children is associated with a substantially higher rate of complications, higher chance of device failure, and worse visual outcomes than observed in adults. In view of these results, the authors do not recommend the use of the KPro in the pediatric population.
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Affiliation(s)
- Simon S M Fung
- Department of Ophthalmology & Visual Sciences, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Samir Jabbour
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Canada
| | - Mona Harissi-Dagher
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Canada
| | - Reginald R G Tan
- Ottawa Hospital Research Institute, University of Ottawa Eye Institute, Ottawa, Canada
| | - Patrick Hamel
- Department of Ophthalmology, CHU Ste-Justine, Montréal, Canada
| | - Kashif Baig
- Ottawa Hospital Research Institute, University of Ottawa Eye Institute, Ottawa, Canada
| | - Asim Ali
- Department of Ophthalmology & Visual Sciences, Hospital for Sick Children, University of Toronto, Toronto, Canada.
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Pang K, Du L, Zhang K, Dai C, Ju C, Zhu J, Wu X. Three-Dimensional Construction of a Rabbit Anterior Corneal Replacement for Lamellar Keratoplasty. PLoS One 2016; 11:e0168084. [PMID: 27930708 PMCID: PMC5145227 DOI: 10.1371/journal.pone.0168084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/25/2016] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to construct a rabbit anterior corneal replacement for transplantation using acellular porcine corneal matrix (APCM) and rabbit epithelial or stromal cells. APCM was prepared from fresh porcine cornea treated with 0.5% (wt./vol.) sodium dodecyl sulfate (SDS) solution. The expanded stromal cells were first injected into APCM parallel to its surface and were cultured in a shaking culture system for 7 days to obtain the stromal construct. Next, corneal epithelial cells were cultured on the stromal construct surface for another 7 days to obtain rabbit anterior corneal lamella. The construct had a phenotype similar to that of normal cornea, with high expression of cytokeratin 3 in the epithelial cell layer and vimentin in the stromal cells. More importantly, the construct integrated well with the implanted host corneal tissue, and the implant cornea maintained transparency in the 6-month follow-up, although there was a slight haze in the central corneal area. The endothelium in the surgery cornea had a similar cell density and mosaic pattern with normal cornea as shown by confocal laser corneal microscopy, and the regenerated corneal epithelial cells on the implant surface showed a similar morphology to that of natural epithelial cells. These results demonstrate that the constructed anterior corneal replacement exhibits an excellent biological property for lamellar keratoplasty and might be a possible alternative to human corneal tissue in the future.
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Affiliation(s)
- Kunpeng Pang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Liqun Du
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Kai Zhang
- Department of Ophthalmology, the Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Chenyang Dai
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Chengqun Ju
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jing Zhu
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xinyi Wu
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- * E-mail:
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