title: Titanium Coating of the Boston Keratoprosthesis.
abstract: OBJECTIVE
  We tested the feasibility of using titanium to enhance adhesion of the Boston Keratoprosthesis (B-KPro), ultimately to decrease the risk of implant-associated complications.
  
  
  METHODS
  Cylindrical rods were made of poly(methyl methacrylate) (PMMA), PMMA coated with titanium dioxide (TiO2) over a layer of polydopamine (PMMATiO2), smooth (Ti) and sandblasted (TiSB) titanium, and titanium treated with oxygen plasma (Tioxand TiSBox). Topography and surface chemistry were analyzed by scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). Adhesion force between rods and porcine corneas was measured ex vivo. Titanium sleeves, smooth and sandblasted, were inserted around the stem of the B-KPro and implanted in rabbits. Tissue adhesion to the stem was assessed and compared to an unmodified B-Kpro after 1 month.
  
  
  RESULTS
  X-ray photoelectron spectroscopy demonstrated successful deposition of TiO2on polydopamine-coated PMMA. Oxygen plasma treatment did not change the XPS spectra of titanium rods (Ti and TiSB), although it increased their hydrophilicity. The materials did not show cell toxicity. After 14 days of incubation, PMMATiO2, smooth titanium treated with oxygen plasma (Tiox), and sandblasted titanium rods (TiSB, TiSBox) showed significantly higher adhesion forces than PMMA ex vivo. In vivo, the use of a TiSBsleeve around the stem of the B-KPro induced a significant increase in tissue adhesion compared to a Ti sleeve or bare PMMA.
  
  
  CONCLUSIONS
  Sandblasted titanium sleeves greatly enhanced adherence of the B-KPro to the rabbit cornea. This approach may improve adhesion with the donor cornea in humans as well.
  
  
  CONCLUSIONS
  This approach may improve adhesion with donor corneas in humans.
authors.affiliation: Department of Ophthalmology Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA ; Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology, Division of Critical Care Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA ; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Borja
authors.initials: B
authors.lastname: Salvador-Culla
authors.affiliation: Department of Chemical Engineering, University of New Hampshire, Durham, NH, USA.
authors.forename: Kyung Jae
authors.initials: KJ
authors.lastname: Jeong
authors.affiliation: Department of Ophthalmology Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Paraskevi Evi
authors.initials: PE
authors.lastname: Kolovou
authors.affiliation: Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology, Division of Critical Care Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA ; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors.forename: Homer H
authors.initials: HH
authors.lastname: Chiang
authors.affiliation: Department of Ophthalmology Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Chodosh
authors.affiliation: Department of Ophthalmology Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Claes H
authors.initials: CH
authors.lastname: Dohlman
authors.affiliation: Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology, Division of Critical Care Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA ; Department of Ophthalmology Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kohane
keywords: Boston Keratoprosthesis; artificial cornea; biointegration; corneal adhesion; keratoprosthesis; titanium adhesion; titanium coating; titanium oxide; titanium skirt