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Berger T, Schlötzer-Schrehardt U, Flockerzi F, Daas L, Flockerzi E, Seitz B. Severe ulcerative keratopathy following implantation of an acellular porcine corneal stromal lenticule in a patient with keratoconus. Cont Lens Anterior Eye 2024; 47:102145. [PMID: 38472013 DOI: 10.1016/j.clae.2024.102145] [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: 11/21/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE To report a case of ulcerative keratopathy following implantation of acellular porcine corneal stroma (APCS) in a patient with keratoconus (KC). METHODS A 58 year-old patient initially presented with an ulcerative keratopathy in the left eye. Previously, several corneal procedures (including radial keratotomy, laser-in-situ keratomileusis, crosslinking) were performed for KC. Eight months ago, an APCS lenticule (Xenia corneal implant, Gebauer Medizintechnik GmbH, Neuhausen, Germany) was implanted into a stromal pocket because of progressive keratectasia. Visual acuity was hand movement. Anterior segment optical coherence tomography showed a space between the APCS lenticule and the host stroma. Excimer laser-assisted penetrating keratoplasty (PKP, 8.0/8.1 mm) was performed in the left eye. The corneal explant was investigated by light and transmission electron microscopy. RESULTS Best-corrected visual acuity was 20/40 six weeks after PKP. Light microscopy demonstrated a stromal ulceration down to the APCS lenticule. No stromal cells could be found within the APCS lenticule eight months after implantation. The APCS lenticule did not show a green stain of the collagens with Masson-Goldner staining and exhibited a strong Periodic acid-Schiff positive reaction. Electron microscopy of the APCS lenticule revealed cross-linked collagen lamellae without cellular components. Close to the interface, corneal collagen lamellae of the host cornea were disorganized. Few vital keratocytes were present on the surface of the lenticule and appeared to cause mechanical disruption of the host stroma along the lenticule-stroma interface. CONCLUSION APCS implantation may lead to severe complications such as ulcerative keratopathy in otherwise uncomplicated KC corneas. In such cases, excimer laser-assisted PKP or Deep Anterior Lamellar Keratoplasty are the methods of choice to restore visual acuity.
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Affiliation(s)
- Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany.
| | | | - Fidelis Flockerzi
- Institute of Pathology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Loay Daas
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Elias Flockerzi
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
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Li X, Chan YT, Jiang Y. Development of an image processing software for quantification of histological calcification staining images. PLoS One 2023; 18:e0286626. [PMID: 37797053 PMCID: PMC10553316 DOI: 10.1371/journal.pone.0286626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 05/22/2023] [Indexed: 10/07/2023] Open
Abstract
Quantification of the histological staining images gives important insights in biomedical research. In wet lab, it is common to have some stains off the target to become unwanted noisy stains during the generation of histological staining images. The current tools designed for quantification of histological staining images do not consider such situations; instead, the stained region is identified based on assumptions that the background is pure and clean. The goal of this study is to develop a light software named Staining Quantification (SQ) tool which could handle the image quantification job with features for removing a large amount of unwanted stains blended or overlaid with Region of Interest (ROI) in complex scenarios. The core algorithm was based on the method of higher order statistics transformation, and local density filtering. Compared with two state-of-art thresholding methods (i.e. Otsu's method and Triclass thresholding method), the SQ tool outperformed in situations such as (1) images with weak positive signals and experimental caused dirty stains; (2) images with experimental counterstaining by multiple colors; (3) complicated histological structure of target tissues. The algorithm was developed in R4.0.2 with over a thousand in-house histological images containing Alizarin Red (AR) and Von Kossa (VK) staining, and was validated using external images. For the measurements of area and intensity in total and stained region, the average mean of difference in percentage between SQ and ImageJ were all less than 0.05. Using this as a criterion of successful image recognition, the success rate for all measurements in AR, VK and external validation batch were above 0.8. The test of Pearson's coefficient, difference between SQ and ImageJ, and difference of proportions between SQ and ImageJ were all significant at level of 0.05. Our results indicated that the SQ tool is well established for automatic histological staining image quantification.
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Affiliation(s)
- Xinrui Li
- School of Medicine, Northwest University, Xi’an, Shaanxi, China
| | - Yau Tsz Chan
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Faculty of Medicine, Institute for Tissue Engineering and Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Key Laboratory for Regenerative Medicine, Ministry of Education, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Shatin, New Territories, Hong Kong, China
| | - Yangzi Jiang
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Faculty of Medicine, Institute for Tissue Engineering and Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Key Laboratory for Regenerative Medicine, Ministry of Education, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Shatin, New Territories, Hong Kong, China
- Faculty of Medicine, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, and Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Kang H, Han Y, Jin M, Zheng L, Liu Z, Xue Y, Liu Z, Li C. Decellularized squid mantle scaffolds as tissue-engineered corneal stroma for promoting corneal regeneration. Bioeng Transl Med 2023; 8:e10531. [PMID: 37476050 PMCID: PMC10354768 DOI: 10.1002/btm2.10531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 07/22/2023] Open
Abstract
Corneal blindness is a worldwide major cause of vision loss, and corneal transplantation remains to be the most effective way to restore the vision. However, often there is a shortage of the donor corneas for transplantation. Therefore, it is urgent to develop a novel tissue-engineered corneal substitute. The present study envisaged the development of a novel and efficient method to prepare the corneal stromal equivalent from the marine biomaterials-squid. A chemical method was employed to decellularize the squid mantle scaffold to create a cell-free tissue substitute using 0.5% sodium dodecyl sulfate (SDS) solution. Subsequently, a novel clearing method, namely clear, unobstructed brain imaging cocktails (CUBIC) method was used to transparent it. Decellularized squid mantle scaffold (DSMS) has high decellularization efficiency, is rich in essential amino acids, and maintains the regular fiber alignment. In vitro experiments showed that the soaking solution of DSMS was non-toxic to human corneal epithelium cells. DSMS exhibited a good biocompatibility in the rat muscle by undergoing a complete degradation, and promoted the growth of the muscle. In addition, the DSMS showed a good compatibility with the corneal stroma in the rabbit inter-corneal implantation model, and promoted the regeneration of the corneal stroma without any evident rejection. Our results indicate that the squid mantle can be a potential new type of tissue-engineered corneal stroma material with a promising clinical application.
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Affiliation(s)
- Honghua Kang
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of MedicineXiamen UniversityXiamenChina
| | - Yi Han
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of MedicineXiamen UniversityXiamenChina
| | - Mengyi Jin
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of MedicineXiamen UniversityXiamenChina
| | - Lan Zheng
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of MedicineXiamen UniversityXiamenChina
| | - Zhen Liu
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
| | - Yuhua Xue
- School of Pharmaceutical SciencesXiamen UniversityXiamenChina
| | - Zuguo Liu
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of MedicineXiamen UniversityXiamenChina
- Department of Ophthalmologythe First Affiliated Hospital of University of South ChinaHengyangHunanChina
| | - Cheng Li
- Eye Institute & Affiliated Xiamen Eye Center, School of MedicineXiamen UniversityXiamenChina
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of MedicineXiamen UniversityXiamenChina
- Department of Ophthalmologythe First Affiliated Hospital of University of South ChinaHengyangHunanChina
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Wang Y, Xu L, Zhao J, Liang J, Zhang Z, Li Q, Zhang J, Wan P, Wu Z. Reconstructing auto tissue engineering lamellar cornea with aspartic acid modified acellular porcine corneal stroma and preconditioned limbal stem cell for corneal regeneration. Biomaterials 2022; 289:121745. [DOI: 10.1016/j.biomaterials.2022.121745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022]
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