[Reticulated polyethylene oxide for gel injection adjustable keratoplasty. Biocompatibility in critical situation].
BACKGROUND
GIAK is a surgical technique developed for the correction of myopia. We evaluated the biocompatibility of a gamma-ray crosslinked poly(ethylene oxide) gel in two critical situations.


METHODS
In 3 rabbits, a 5 mm inner diameter annular channel of 1 mm width was delaminated at 80% corneal depth and a sterile gamma-ray crosslinked polyethylene oxide gel was injected in the channel. In cornea 1 (control), the annulus was centered on the corneal apex and the channel was fully filled with gel. In cornea 2, the delamination was purposely decentered and the channel was approximately 1 mm from the limbus at its closest point. In cornea 3, the centered channel was purposely partially filled. After a 6 month follow-up, the rabbits were sacrificed for histology.


RESULTS
Histopathology showed the oval channel walls to be irregular and a slight thinning of the epithelium located above the implant but no abnormalities in the stromal thickness. No mononuclear, polynuclear cells or other signs of encapsulation or rejection were found around the polymer in any of the animals. In cornea 3, fibroblasts were found on the lateral sides of the hydrogel globules. No limbal neovascularization was observed over the 6 month period in any of the animals.


CONCLUSIONS
The injected PEO gel followed intimately the delaminated stromal channel and was well tolerated in the cornea. The fibroblastic reaction found in partially filled channels is caused by the normal wound healing process and not by the hydrogel chemical properties.
Legeais
J M
JM
Service d'Ophtalmologie de l'Hôtel-Dieu de Paris, Université de Paris VI, INSERM U86.
Parel
J M
JM
Savoldelli
M
M
Villain
F L
FL
D'Hermies
F
F
Renard
G
G
Pouliquen
Y
Y
D000818:Animals; D003315:Cornea / Q000601:surgery* / Q000648:ultrastructure; D005782:Gels; D007267:Injections; D008422:Materials Testing; D008854:Microscopy, Electron; D011092:Polyethylene Glycols; D019736:Prostheses and Implants; D011817:Rabbits
D005782:Gels; D011092:Polyethylene Glycols
Oxyde de polyéthylène réticulé pour kératoplastie ajustable par injection de gel (GIAK). Biocompatibilité en situation critique.