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Procházková A, Poláchová M, Dítě J, Netuková M, Studený P. Chemical, Physical, and Biological Corneal Decellularization Methods: A Review of Literature. J Ophthalmol 2024; 2024:1191462. [PMID: 38567029 PMCID: PMC10985644 DOI: 10.1155/2024/1191462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
The cornea is one of the most commonly transplanted tissues worldwide. It is used to restore vision when severe visual impairment or blindness occurs in patients with corneal diseases or after trauma. Due to the global shortage of healthy donor corneas, decellularized corneal tissue has significant potential as an alternative to corneal transplantation. It preserves the native and biological ultrastructure of the cornea and, therefore, represents the most promising scaffold. This article discusses different methods of corneal decellularization based on the current literature. We searched PubMed.gov for articles from January 2009 to December 2023 using the following keywords: corneal decellularization, decellularization methods, and corneal transplantation. Although several methods of decellularization of corneal tissue have been reported, a universal standardised protocol of corneal decellularization has not yet been introduced. In general, a combination of decellularization methods has been used for efficient decellularization while preserving the optimal properties of the corneal tissue.
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Affiliation(s)
- Alexandra Procházková
- Department of Ophthalmology, Kralovske Vinohrady University Hospital and 3rd Medical Faculty, Srobarova 1150/50, Prague 10 100 34, Czech Republic
| | - Martina Poláchová
- Department of Ophthalmology, Kralovske Vinohrady University Hospital and 3rd Medical Faculty, Srobarova 1150/50, Prague 10 100 34, Czech Republic
| | - Jakub Dítě
- Department of Ophthalmology, Kralovske Vinohrady University Hospital and 3rd Medical Faculty, Srobarova 1150/50, Prague 10 100 34, Czech Republic
| | - Magdaléna Netuková
- Department of Ophthalmology, Kralovske Vinohrady University Hospital and 3rd Medical Faculty, Srobarova 1150/50, Prague 10 100 34, Czech Republic
| | - Pavel Studený
- Department of Ophthalmology, Kralovske Vinohrady University Hospital and 3rd Medical Faculty, Srobarova 1150/50, Prague 10 100 34, Czech Republic
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Aghamollaei H, Hashemi H, Fallahtafti M, Daryabari SH, Khabazkhoob M, Jadidi K. Applications of SMILE-extracted lenticules in ophthalmology. Int J Ophthalmol 2024; 17:173-187. [PMID: 38239948 PMCID: PMC10754658 DOI: 10.18240/ijo.2024.01.23] [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: 05/12/2023] [Accepted: 10/20/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To review recent innovations, challenges, and applications of small incision lenticule extraction (SMILE) extracted lenticule for treating ocular disorders. METHODS A literature review was performed in the PubMed database, which was last updated on 30 December 2021. There was no limit regarding language. The authors evaluated the reference lists of the collected papers to find any relevant research. RESULTS Due to the simplicity and accuracy of modern femtosecond lasers and the extensive development of SMILE surgery, many healthy human corneal stromal lenticules were extracted during surgery, motivating some professionals to investigate the SMILE lenticule reusability in different ocular disorders. In addition, new approaches had been developed to preserve, modify, and bioengineer the corneal stroma, leading to the optimal use of discarded byproducts such as lenticules from SMILE surgery. The lenticules can be effectively re-implanted into the autologous or allogenic corneas of human subjects to treat refractive errors, corneal ectasia, and corneal perforation and serve as a patch graft for glaucoma drainage devices with better cosmetic outcomes. CONCLUSION SMILE-extracted lenticules could be a viable alternative to human donor corneal tissue.
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Affiliation(s)
- Hossein Aghamollaei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran 1968653111, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran 1983963113, Iran
| | - Mahsa Fallahtafti
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan 1914853185, Iran
| | - Seyed-Hashem Daryabari
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran 1968653111, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1968653111, Iran
| | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan 1914853185, Iran
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Miyai T, Toyono T, Ishii H, Kitamoto K, Taketani Y, Ono T, Aihara M, Miyata K. Epikeratophakia for Keratoconus: A Case Report with 30 Years of Follow-Up. Case Rep Ophthalmol Med 2023; 2023:9919057. [PMID: 38022733 PMCID: PMC10651333 DOI: 10.1155/2023/9919057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/12/2023] [Accepted: 08/29/2023] [Indexed: 12/01/2023] Open
Abstract
Background Epikeratophakia is a refractive surgical procedure used to correct aphakic eyes, hyperopia, and keratoconus and is often performed in children. In this report, we present the long-term effects of epikeratophakia on the progression of keratoconus in a patient who underwent surgery. Case Presentation. The patient was a 17-year-old boy with keratoconus who had difficulty wearing hard contact lenses. As a solution, he underwent right eye epikeratophakia with a plano-powered lenticule. We followed up the patient for 30 years. Although the progression of keratoconus ceased in the operated eye, it continued in the nonoperated left eye and resulted in acute hydrops 9 years and 10 months after surgery. Subsequently, 20 years after the operation, anterior-segment optical coherence tomography was performed, which revealed that the progression of keratoconus had been interrupted in the right eye but had continued in the left eye, as evidenced by the parameters of the average and maximum keratometry and thinnest corneal thickness. Conclusions Herein, we reported the longest follow-up to date of a case of keratoconus, in which one eye was treated with epikeratophakia. The progression of keratoconus was halted in the treated eye but continued in the nonoperated contralateral eye.
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Affiliation(s)
- Takashi Miyai
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Toyono
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hitoha Ishii
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Kohdai Kitamoto
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yukako Taketani
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takashi Ono
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Saif MS, Hasan M, Zafar A, Ahmed MM, Tariq T, Waqas M, Hussain R, Zafar A, Xue H, Shu X. Advancing Nanoscale Science: Synthesis and Bioprinting of Zeolitic Imidazole Framework-8 for Enhanced Anti-Infectious Therapeutic Efficacies. Biomedicines 2023; 11:2832. [PMID: 37893205 PMCID: PMC10604899 DOI: 10.3390/biomedicines11102832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Bacterial infectious disorders are becoming a major health problem for public health. The zeolitic imidazole framework-8 with a novel Cordia myxa extract-based (CME@ZIF-8) nanocomposite showed variable functionality, high porosity, and bacteria-killing activity against Staphylococcus aureus, and Escherichia coli strains have been created by using a straightforward approach. The sizes of synthesized zeolitic imidazole framework-8 (ZIF-8) and CME@ZIF-8 were 11.38 nm and 12.44 nm, respectively. Prepared metal organic frameworks have been characterized by gas chromatography-mass spectroscopy, Fourier transform spectroscopy, UV-visible spectroscopy, X-ray diffraction, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. An antibacterial potential comparison between CME@ZIF-8 and zeolitic imidazole framework-8 has shown that CME@ZIF-8 was 31.3%, 28.57%, 46%, and 47% more efficient than ZIF-8 against Staphylococcus aureus and 43.7%, 42.8%, 35.7%, and 70% more efficient against Escherichia coli, while it was 31.25%, 33.3%, 46%, and 46% more efficient than the commercially available ciprofloxacin drug against Staphylococcus aureus and 43.7%, 42.8%, 35.7%, and 70% more efficient against Escherichia coli, respectively, for 750, 500, 250, and 125 μg mL-1. Minimum inhibitory concentration values of CME@ZIF-8 for Escherichia coli and Staphylococcus aureus were 15.6 and 31.25 μg/mL respectively, while the value of zeolitic imidazole framework-8 alone was 62.5 μg/mL for both Escherichia coli and Staphylococcus aureus. The reactive oxygen species generated by CME@ZIF-8 destroys the bacterial cell and its organelles. Consequently, the CME@ZIF-8 nanocomposites have endless potential applications for treating infectious diseases.
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Affiliation(s)
- Muhammad Saqib Saif
- Faculty of Chemical and Biological Science, Department of Biochemistry, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; (M.S.S.)
| | - Murtaza Hasan
- Faculty of Chemical and Biological Science, Department of Biotechnology, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
- School of Chemistry and Chemical Engineering, Zhongkai University of Agriculture and Engineering, Guangzhou 510225, China
| | - Ayesha Zafar
- School of Engineering, Royal Melbourne Institute of Technology (RMIT) University, 24 La Trobe Street, Melbourne, VIC 3001, Australia;
| | - Muhammad Mahmood Ahmed
- Faculty of Chemical and Biological Science, Department of Bioinformatics, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; (M.M.A.)
| | - Tuba Tariq
- Faculty of Chemical and Biological Science, Department of Biochemistry, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; (M.S.S.)
| | - Muhammad Waqas
- Faculty of Chemical and Biological Science, Department of Biotechnology, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Riaz Hussain
- Faculty of Chemical and Biological Science, Department of Veterinary Sciences, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Amna Zafar
- Faculty of Chemical and Biological Science, Department of Bioinformatics, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; (M.M.A.)
| | - Huang Xue
- School of Chemistry and Chemical Engineering, Zhongkai University of Agriculture and Engineering, Guangzhou 510225, China
| | - Xugang Shu
- School of Chemistry and Chemical Engineering, Zhongkai University of Agriculture and Engineering, Guangzhou 510225, China
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Thirunavukarasu AJ, Han E, Nedumaran AM, Kurz AC, Shuman J, Yusoff NZBM, Liu YC, Foo V, Czarny B, Riau AK, Mehta JS. Electron beam-irradiated donor cornea for on-demand lenticule implantation to treat corneal diseases and refractive error. Acta Biomater 2023; 169:334-347. [PMID: 37532130 DOI: 10.1016/j.actbio.2023.07.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/07/2023] [Accepted: 07/26/2023] [Indexed: 08/04/2023]
Abstract
The cornea is the major contributor to the refractive power of the eye, and corneal diseases are a leading cause of reversible blindness. The main treatment for advanced corneal disease is keratoplasty: allograft transplantation of the cornea. Examples include lenticule implantation to treat corneal disorders (e.g. keratoconus) or correct refractive errors. These procedures are limited by the shelf-life of the corneal tissue, which must be discarded within 2-4 weeks. Electron-beam irradiation is an emerging sterilisation technique, which extends this shelf life to 2 years. Here, we produced lenticules from fresh and electron-beam (E-beam) irradiated corneas to establish a new source of tissue for lenticule implantation. In vitro, in vivo, and ex vivo experiments were conducted to compare fresh and E-beam-irradiated lenticules. Results were similar in terms of cutting accuracy, ultrastructure, optical transparency, ease of extraction and transplantation, resilience to mechanical handling, biocompatibility, and post-transplant wound healing process. Two main differences were noted. First, ∼59% reduction of glycosaminoglycans resulted in greater compression of E-beam-irradiated lenticules post-transplant, likely due to reduced corneal hydration-this appeared to affect keratometry after implantation. Cutting a thicker lenticule would be required to ameliorate the difference in refraction. Second, E-beam-sterilised lenticules exhibited lower Young's modulus which may indicate greater care with handling, although no damage or perforation was caused in our procedures. In summary, E-beam-irradiated corneas are a viable source of tissue for stromal lenticules, and may facilitate on-demand lenticule implantation to treat a wide range of corneal diseases. Our study suggested that its applications in human patients are warranted. STATEMENT OF SIGNIFICANCE: Corneal blindness affects over six million patients worldwide. For patients requiring corneal transplantation, current cadaver-based procedures are limited by the short shelf-life of donor tissue. Electron-beam (E-beam) sterilisation extends this shelf-life from weeks to years but there are few published studies of its use. We demonstrated that E-beam-irradiated corneas are a viable source of lenticules for implantation. We conducted in vitro, in vivo, and ex vivo comparisons of E-beam and fresh corneal lenticules. The only differences exhibited by E-beam-treated lenticules were reduced expression of glycosaminoglycans, resulting in greater tissue compression and lower refraction suggesting that a thicker cut is required to achieve the same optical and refractive outcome; and lower Young's modulus indicating extra care with handling.
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Affiliation(s)
- Arun J Thirunavukarasu
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Evelina Han
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore
| | - Anu Maashaa Nedumaran
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
| | | | | | | | - Yu-Chi Liu
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Valencia Foo
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore
| | - Bertrand Czarny
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
| | - Andri K Riau
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.
| | - Jodhbir S Mehta
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; School of Materials Science and Engineering, Nanyang Technological University, Singapore; Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.
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Moshirfar M, Stoakes IM, Bruce EG, Ali A, Payne CJ, Furhiman D, Ronquillo YC, Hoopes PC. Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review. Ophthalmol Ther 2023; 12:2361-2379. [PMID: 37516716 PMCID: PMC10442033 DOI: 10.1007/s40123-023-00765-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/31/2023] Open
Abstract
INTRODUCTION Intrastromal lenticule implantation is a promising treatment option for corneal pathologies, from refractive error to ectasia. In this narrative review, we intend to feature up-to-date literature supporting the use of lenticular tissue, a compelling method that can be customized for a variety of applications, providing an additional source of donor tissue for treating corneal diseases. METHODS We searched databases PubMed, Mendeley, and Scopus last accessed 10 May 2023, for literature on stromal lenticules and narrowed based on relevance. Review articles, animal studies, ex vivo studies, and book chapters were excluded, while assessable and relevant articles published in English were included. RESULTS Storage methods from using fresh lenticules to dehydration have proven successful, with cryopreservation maintaining structure and cellular viability for up to 10 years. Successful use of lenticules for treatment of numerous pathologies including corneal ectasias, hyperopia, and presbyopia with additional insight into the treatment of corneal ulcers and perforations are highlighted in this narrative review. CONCLUSION Lenticular implantation is an innovative and advantageous treatment for various ocular pathologies, offering increased bioavailability, flexibility, and customization for patients. They can treat previously untreatable diseases and serve as a replacement for synthetic implants, with promising outcomes worldwide. Lenticular implantation has the potential to become a leading approach in ophthalmologic surgery. Further studies should aim to provide evidentiary support for a standardization of lenticule banking.
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Affiliation(s)
- Majid Moshirfar
- HDR Research Center, Hoopes Vision, Draper, UT, USA.
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
| | - Isabella M Stoakes
- HDR Research Center, Hoopes Vision, Draper, UT, USA
- Pacific Northwest University of Health Sciences, Yakima, WA, USA
| | | | - Amir Ali
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Carter J Payne
- HDR Research Center, Hoopes Vision, Draper, UT, USA
- Case Western Reserve School of Medicine, Cleveland, OH, USA
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Wang X, Elbahrawi RT, Abdukadir AM, Ali ZM, Chan V, Corridon PR. A proposed model of xeno-keratoplasty using 3D printing and decellularization. Front Pharmacol 2023; 14:1193606. [PMID: 37799970 PMCID: PMC10548234 DOI: 10.3389/fphar.2023.1193606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Abstract
Corneal opacity is a leading cause of vision impairment and suffering worldwide. Transplantation can effectively restore vision and reduce chronic discomfort. However, there is a considerable shortage of viable corneal graft tissues. Tissue engineering may address this issue by advancing xeno-keratoplasty as a viable alternative to conventional keratoplasty. In particular, livestock decellularization strategies offer the potential to generate bioartificial ocular prosthetics in sufficient supply to match existing and projected needs. To this end, we have examined the best practices and characterizations that have supported the current state-of-the-art driving preclinical and clinical applications. Identifying the challenges that delimit activities to supplement the donor corneal pool derived from acellular scaffolds allowed us to hypothesize a model for keratoprosthesis applications derived from livestock combining 3D printing and decellularization.
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Affiliation(s)
- Xinyu Wang
- Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Rawdah Taha Elbahrawi
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Azhar Mohamud Abdukadir
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Zehara Mohammed Ali
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Vincent Chan
- Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Peter R. Corridon
- Biomedical Engineering and Healthcare Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University, Abu Dhabi, United Arab Emirates
- Hleathcare, Engineering and Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
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Urbánek P, Šuly P, Ševčík J, Hanulíková B, Kuřitka I, Šopík T, Stodůlka P. Controlled Drug Delivery Device for Cornea Treatment and Novel Method for Its Testing. Pharmaceuticals (Basel) 2023; 16:ph16040505. [PMID: 37111260 PMCID: PMC10143253 DOI: 10.3390/ph16040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
A new solution for local anesthetic and antibiotic delivery after eye surgery is presented. A contact lens-shaped collagen drug carrier was created and loaded by Levofloxacin and Tetracaine with a riboflavin crosslinked surface layer, thus impeding diffusion. The crosslinking was confirmed by Raman spectroscopy, whereas the drug release was investigated using UV-Vis spectrometry. Due to the surface barrier, the drug gradually releases into the corneal tissue. To test the function of the carrier, a 3D printed device and a new test method for a controlled drug release, which mimics the geometry and physiological lacrimation rate of the human eye, were developed. The experimental setup with simple geometry revealed that the prepared drug delivery device can provide the prolonged release profile of the pseudo-first-order for up to 72 h. The efficiency of the drug delivery was further demonstrated using a dead porcine cornea as a drug recipient, without the need to use live animals for testing. Our drug delivery system significantly surpasses the efficiency of antibiotic and anesthetic eyedrops that would have to be applied approximately 30 times per hour to achieve the same dose as that delivered continuously by our device.
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Affiliation(s)
- Pavel Urbánek
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
- Correspondence:
| | - Pavol Šuly
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Jakub Ševčík
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Barbora Hanulíková
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Ivo Kuřitka
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Tomáš Šopík
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Pavel Stodůlka
- Gemini Eye Clinic, U Gemini 360, 76001 Zlin, Czech Republic
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Wilson A, Jones J, Marshall J. Biomechanical Evaluation of Decellularized and Crosslinked Corneal Implants Manufactured From Porcine Corneas as a Treatment Option for Advanced Keratoconus. Front Bioeng Biotechnol 2022; 10:862969. [PMID: 35497356 PMCID: PMC9046912 DOI: 10.3389/fbioe.2022.862969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/14/2022] [Indexed: 01/13/2023] Open
Abstract
Currently corneal transplantation is the main treatment for late-stage keratoconus; however, transplantation procedures are accompanied by significant risk of post-surgical complications; this in addition to supply limitations imposed by a worldwide shortage of human donor corneas, has driven the development of alternative therapies. One such therapy is the use of corneal implants derived from porcine corneas (Xenia®, Gebauer Medizintechnik GmbH, Neuhausen, DE). In contrast to human donor tissue, these implants can be produced on demand and due to the processes used pose no risks for host-immune rejection. Their use has already been demonstrated clinically in patients for preventing the progression of topographic changes in keratoconus whilst improving visual acuity. The implants are derived from natural tissue and not standardised synthetic material, whilst this likely reduces the risk of issues with bio-incompatibility, there is inevitably variability in their intrinsic mechanical properties which requires investigation. Here, speckle interferometry is employed to examine the biomechanical properties, in response to physiologically representative forces, of native porcine corneal tissue prior to processing and after a proprietary 4-stage process involving decellularization, washing, compression and crosslinking. The control lenticules had an average Young’s modulus (E) of 11.11 MPa (range 8.39–13.41 MPa), following processing average E of the lenticules increased by 127% over that of the unprocessed tissue to 25.23 MPa (range 18.32–32.9 MPa). The variability in E of the lenticules increased significantly after processing suggesting variability in the propensity of the native tissue to processing. In summary, it is possible to produce thin (<90 µm) lenticules from porcine corneas with enhanced stiffness that are effective for treating late-stage keratoconus. Due to the observed variability in the responses of lenticules to processing, interferometry could be a useful technique for ensuring quality control in commercial production via biomechanical screening.
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Affiliation(s)
- Abby Wilson
- UCL Mechanical Engineering, London, United Kingdom
- Institute of Ophthalmology, UCL, London, United Kingdom
- *Correspondence: Abby Wilson,
| | - John Jones
- Laser Optical Engineering Ltd., Donington, United Kingdom
| | - John Marshall
- Institute of Ophthalmology, UCL, London, United Kingdom
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