title: Long-term follow-up of a supradescemetic keratoprosthesis in rabbits: an immunofluorescence study.
abstract: 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.
authors.affiliation: 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
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Espana
authors.forename: Ana C
authors.initials: AC
authors.lastname: Acosta
authors.forename: Josef
authors.initials: J
authors.lastname: Stoiber
authors.forename: Viviana
authors.initials: V
authors.lastname: Fernandez
authors.forename: Peggy D
authors.initials: PD
authors.lastname: Lamar
authors.forename: Franck L
authors.initials: FL
authors.lastname: Villain
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lacombe
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alfonso
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Parel
mesh_terms: 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
chemical_list: D000199:Actins; D001672:Biocompatible Materials; D024141:Collagen Type IV; D008768:Methylmethacrylates; D011102:Polyhydroxyethyl Methacrylate; C040206:HTR composite; D019904:Polymethyl Methacrylate
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