Long-term follow-up of a supradescemetic keratoprosthesis in rabbits: an immunofluorescence study.
OBJECTIVE
To evaluate the long-term clinical and immunohistological outcome of two different non-penetrating keratoprosthesis (KPro) implanted in non-injured rabbit corneas.


METHODS
Three rabbits underwent implantation of a pHEMA-MMA(34) synthetic cornea in the supradescemetic space, and PMMA synthetic corneas in the supradescemetic space and within the central stroma. Animals were followed for at least 24 months before euthanasia. Periodic evaluation was performed with slit-lamp examination and photography. At the end of the follow-up, histological examination including hematoxylin eosin staining and immunocharacterization against collagen IV, alpha smooth muscle actin (α-SMA) and macrophages was performed.


RESULTS
The pHEMA-MMA(34) implant was not extruded, and remained transparent until the end of follow-up. This material did not induce any cell infiltration, corneal scarring or tissue remodeling in the surrounding stroma as shown by immunofluorescence. In contrast, synthetic corneas made of PMMA-induced myofibroblast differentiation, stromal remodeling and macrophage infiltration. This reaction was even more significant in the rabbit with the PMMA implant within the corneal stroma.


CONCLUSIONS
pHEMA-MMA(34) was clinically biocompatible, and did not induce any inflammatory reaction or scarring when implanted in the supradescemetic space. This material showed more promising biocompatibility results than for PMMA, whether implanted within the central cornea stroma or in the supradescemetic space.
Espana
Edgar M
EM
Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Avenue, Miami, FL 33136, USA. edgarespanamd@gmail.com
Acosta
Ana C
AC
Stoiber
Josef
J
Fernandez
Viviana
V
Lamar
Peggy D
PD
Villain
Franck L
FL
Lacombe
Emmanuel
E
Alfonso
Eduardo
E
Parel
Jean-Marie
JM
D000199:Actins / Q000378:metabolism; D000818:Animals; D001187:Artificial Organs; D001672:Biocompatible Materials; D024141:Collagen Type IV / Q000378:metabolism; D003319:Corneal Stroma / Q000276:immunology; D003886:Descemet Membrane / Q000378:metabolism / Q000601:surgery* / Q000648:ultrastructure; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D008264:Macrophages / Q000502:physiology; D008422:Materials Testing; D008768:Methylmethacrylates; D058628:Myofibroblasts / Q000378:metabolism; D011102:Polyhydroxyethyl Methacrylate; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D011817:Rabbits
D000199:Actins; D001672:Biocompatible Materials; D024141:Collagen Type IV; D008768:Methylmethacrylates; D011102:Polyhydroxyethyl Methacrylate; C040206:HTR composite; D019904:Polymethyl Methacrylate
Surv Ophthalmol. 1997 Sep-Oct;42(2):175-89
9381372
Cornea. 2001 Aug;20(6):647-50
11473169
Exp Eye Res. 2003 Jan;76(1):71-87
12589777
Trans Am Ophthalmol Soc. 1997;95:751-802
9440192
Invest Ophthalmol Vis Sci. 1995 Apr;36(5):809-19
7706029
Cornea. 2005 May;24(4):467-73
15829807
J Biol Chem. 1996 Dec 6;271(49):31431-6
8940154
Cornea. 2005 Nov;24(8):893-4
16227829
J Biol Chem. 2001 Nov 23;276(47):44173-8
11555658
Curr Opin Ophthalmol. 2001 Aug;12(4):282-7
11507341
Curr Eye Res. 1997 Apr;16(4):339-48
9134323
Prog Retin Eye Res. 2001 Sep;20(5):625-37
11470453
Arch Ophthalmol. 2005 Oct;123(10):1319-29
16219722
Invest Ophthalmol Vis Sci. 1998 Feb;39(2):276-83
9477983
Invest Ophthalmol Vis Sci. 1998 Feb;39(2):220-6
9477978
Cornea. 1996 Sep;15(5):505-16
8862928
Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977 Mar-Apr;83(2):271-80
327658
Arch Ophthalmol. 2004 Dec;122(12):1850-5
15596590
Prog Retin Eye Res. 1999 May;18(3):311-56
10192516
Br J Ophthalmol. 2003 Dec;87(12):1509-14
14660463
J Refract Surg. 1997 Jan-Feb;13(1):74-8
9049939
Trans Am Ophthalmol Soc. 1969;67:207-34
5381298