Evaluation of corneal cell growth on tissue engineering materials as artificial cornea scaffolds

The keratoprosthesis(KPro;artificial cornea)is a special refractive device to replace human cornea by using heterogeneous forming materials for the implantation into the damaged eyes in order to obtain a certain vision.The main problems of artificial cornea are the biocompatibility and stability of the tissue particularly in penetrating keratoplasty.The current studies of tissue-engineered scaffold materials through comprising composites of natural and synthetic biopolymers together have developed a new way to artificial cornea.Although a wide agreement that the long-term stability of these devices would be greatly improved by the presence of cornea cells,modification of keratoprosthesis to support cornea cells remains elusive.Most of the studies on corneal substrate materials and surface modification of composites have tried to improve the growth and biocompatibility of cornea cells which can not only reduce the stimulus of heterogeneous materials,but also more importantly continuous and stable cornea cells can prevent the destruction of collagenase.The necrosis of stroma and spontaneous extrusion of the device,allow for maintenance of a precorneal tear layer,and play the role of ensuring a good optical surface and resisting bacterial infection.As a result,improvement in corneal cells has been the main aim of several recent investigations;some effort has focused on biomaterial for its well biological properties such as promoting the growth of cornea cells.The purpose of this review is to summary the growth status of the corneal cells after the implantation of several artificial corneas.

Forty-five years of keratoprosthesis study and application at the Filatov Institute: a retrospective analysis of 1060 cases

AIM: To present results of the keratoprosthesis method used at The Filatov Institute of Eye Diseases and Tissue Therapy. ·METHODS: A retrospective case series analysis was used to describe the development of new types of keratoprostheses and methods of implantation as well as different ways of leukoma strengthening. ·RESULTS: Keratoprosthesis was performed in 1 060 eyes of 1 040 patients with leukomas of different etiology: burns, 725 eyes (68.4% ); trauma, 120 eyes (11.3% ); keratitis and ocular pemphigoid, 108 eyes (10.2% ); and bullous keratopathy, 107 eyes (10.1% ). Visual acuity before keratoprosthesis consisted of light perception in 962 eyes (92% ), and 98 eyes (8% ) had minimal visual acuity (1/200-1/50). Both eyes were blind (visual acuity less than 1/200) in 955 patients (91.8% ). The period of blindness varied from 1 to 52 years. As a result of keratoprosthesis, visual acuity of ≥1/200 was restored in 1 023 of 1 060 eyes (96.5%). Visual acuity of 20/200-20/20 was achieved in 716 eyes (67.5%). At the last follow-up visit visual acuity of ≥1/200 was preserved in 806 eyes (76%), visual acuity of 20/200-20/20 was measured in 583 of 1 060 eyes (55%) and good keratoprosthesis fixation in the cornea was achieved in 986 of 1 060 eyes (93%). The minimal follow-up was 12 months (range, 12 months to 37 years, median 5 years). · CONCLUSION: Our techniques of keratoprosthesis effectively restore vision in patients with leukomas that cannot be treated by optical corneal grafting.

In vivo biological stability of chemically pretreated silicone gel inserts intended for use in keratoprostheses

Background Pretreatment with chemical agents could alter the surface chemistry of the silicone gel, which makes it suitable for epithelial migration onto its surface and thus enhances the cytobiocompatibility. This study aimed to evaluate the biological response of the corneal stroma to porous silicone gel pretreated with different chemical agents in vivo. Methods The porous silicone gels were treated with a mixed acid solution containing 23.2% H2SO4 and 0.8% K2Cr207 for 10 or 15 minutes or with 30% H202 for 15 minutes. Discs （4 mm in diameter） were inserted into interlamellar stromal pockets of New Zealand white rabbits and followed up for a period of 3 months. Clinical evaluations such as corneal infiltration, edema and neovascularization were performed daily. At 3 months, the fibroplasias and collagen deposition were examined under light and scanning electron microscopy （SEM） and by immunohistochemical analysis. Results Pretreatment of the discs obviously decreased conjunctival congestion, discharge, cornea edema, and the extent of neovascularization. More fibroblasts migrated into the pretreated discs than into the control, and collagen was deposited, indicating that the biocompatibility of the corneal replacements was enhanced by the chemical pretreatments. From immunohistochemical analysis, Type I collagen deposition in the pretreated silicone discs was greater than in the control. Conclusions Chemical treatment of silicone gel is effective in decreasing rabbit corneal inflammation, encouraging fibroblast in-growth, and enhancing tissue compatibility. Pretreated gels show good biological stability when used as a skirt material in Keratoprosthesis （Kpros）.

Effect of chemical treatment of silicon gel on tissue compatibility

Background Silicon gel is unfavourable for cell attachment and growth. This study was to study if pretreating the surface of silicon gel with chemical agents affects the proliferation of epithelial cells Methods Silicon gel was made and treated with either mixed acid solution (containing 232 g/dm 3 of H 2SO 4 and 8 g/dm 3 of K 2Cr 2O 7) or 300 cm 3/dm 3 peroxide for 5, 10, and 15 minutes or 10, 15, and 20 minutes, respectively The cultured corneal epithelial cells were seeded onto those silicon gels and kept for 13 days Immunohistochemical investigations were then carried out for integrin (alpha 6 or beta 4) and actin KH*2/5DResults Growth of the epithelial cells in silicon gels treated with mixed acid solution for 10 minutes and 15 minutes was much significant than that in the untreated gels After a 12-hour culture, a small number of corneal epithelial cells were proliferated on the surface of the silicon gels that had been treated with peroxide for 15 minutes After a 3-day culture, those cells were further proliferated and fused together The corneal epithelial cells did not grow well in the silicon gels treated with peroxide for 10 or 20 minutes Immunostaining revealed the expression of actin and integrin alpha 6 or beta 4 on the silicon gels that were treated with mixed acid solution for 10 minutes or peroxide for 15 minutes Conclusion Silicon gels treated either with mixed acid solution for 10 or 15 minutes or with peroxide for 15 minutes improves cell proliferation