Aktuelle Versorgungsmöglichkeiten mit Keratoprothesen

Schrage, Norbert; Hille, K.; Cursiefen, Claus

doi:10.1007/s00347-013-3009-5

Cited by 27 publications

(7 citation statements)

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“…Artificial corneas in the form of prostheses have been introduced in clinics, most n o t a b l y t h e B o s t o n K P r o , A l p h a C o r , a n d osteo-odonto-keratoprosthesis (OOKP) [2][3][4]. All three prostheses are associated with potentially serious side effects and are regarded as a last resort treatment for patients with severe pathology or previous conventional graft failures [5]. Given the shortcomings of conventional corneal transplantation and insufficient performance of prostheses, various research groups have focused on the development of a range of corneal replacements [6,7].…”

Section: Introductionmentioning

confidence: 99%

Plant Recombinant Human Collagen Type I Hydrogels for Corneal Regeneration

Haagdorens

Edin

Groleau

et al. 2021

Regen. Eng. Transl. Med.

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Purpose To determine feasibility of plant-derived recombinant human collagen type I (RHCI) for use in corneal regenerative implants Methods RHCI was crosslinked with 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS) to form hydrogels. Application of shear force to liquid crystalline RHCI aligned the collagen fibrils. Both aligned and random hydrogels were evaluated for mechanical and optical properties, as well as in vitro biocompatibility. Further evaluation was performed in vivo by subcutaneous implantation in rats and corneal implantation in Göttingen minipigs. Results Spontaneous crosslinking of randomly aligned RHCI (rRHCI) formed robust, transparent hydrogels that were sufficient for implantation. Aligning the RHCI (aRHCI) resulted in thicker collagen fibrils forming an opaque hydrogel with insufficient transverse mechanical strength for surgical manipulation. rRHCI showed minimal inflammation when implanted subcutaneously in rats. The corneal implants in minipigs showed that rRHCI hydrogels promoted regeneration of corneal epithelium, stroma, and nerves; some myofibroblasts were seen in the regenerated neo-corneas. Conclusion Plant-derived RHCI was used to fabricate a hydrogel that is transparent, mechanically stable, and biocompatible when grafted as corneal implants in minipigs. Plant-derived collagen is determined to be a safe alternative to allografts, animal collagens, or yeast-derived recombinant human collagen for tissue engineering applications. The main advantage is that unlike donor corneas or yeast-produced collagen, the RHCI supply is potentially unlimited due to the high yields of this production method. Lay Summary A severe shortage of human-donor corneas for transplantation has led scientists to develop synthetic alternatives. Here, recombinant human collagen type I made of tobacco plants through genetic engineering was tested for use in making corneal implants. We made strong, transparent hydrogels that were tested by implanting subcutaneously in rats and in the corneas of minipigs. We showed that the plant collagen was biocompatible and was able to stably regenerate the corneas of minipigs comparable to yeast-produced recombinant collagen that we previously tested in clinical trials. The advantage of the plant collagen is that the supply is potentially limitless.

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Section: Introductionmentioning

confidence: 99%

Plant Recombinant Human Collagen Type I Hydrogels for Corneal Regeneration

Haagdorens

Edin

Groleau

et al. 2021

Regen. Eng. Transl. Med.

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“…Da die Anwendung von Keratoprothesen einen komplexen Eingriff bedeutet, der eine mitunter langwierige Nachsorge benötigt, empfiehlt es sich, deren Einsatz als letztes Mittel für Patienten zu reservieren, bei denen alle anderen Behandlungsoptionen erfolglos blieben. Zur Therapie der LSZI wurden in der klinischen Anwendung verschiedene Modelle verwendet [41]. Davon wurden bislang 2 Modelle in einem größeren Umfang und über längere Zeiträume eingesetzt, sodass entsprechende Daten zur Bewertung der Wirksamkeit vorliegen.…”

Section: Einsatz Von Keratoprothesenunclassified

“…Davon wurden bislang 2 Modelle in einem größeren Umfang und über längere Zeiträume eingesetzt, sodass entsprechende Daten zur Bewertung der Wirksamkeit vorliegen. Dabei handelt es sich um die Osteoodontokeratoprothese, (OOKP) und die Boston-Keratoprothese (BKP) [41]. Bei der Technik der OOKP wird die Keratoprothese vollständig in die Augenoberfläche integriert.…”

Section: Einsatz Von Keratoprothesenunclassified

“…Dazu wird mithilfe einer autologen Knochenlamina aus der Zahnwurzel eines einwurzeligen Zahnes ein Träger für einen optischen Zylinder aus Kunststoff (Polymethylmethacrylat = PMMA) generiert und zentral in das Auge eingesetzt. Zum Schutz dieses Komplexes wird Schleimhaut, meistens Mundschleimhaut, zur Deckung der Bindehaut verwendet [41,42]. Die OOKP wurde bereits 1963 beschrieben und in der Folgezeit weiterentwickelt und eingesetzt.…”

Section: Einsatz Von Keratoprothesenunclassified

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Optische Rehabilitation nach Limbusstammzellinsuffizienz: aktuelle Behandlungsmöglichkeiten und Entwicklungen

Thomasen

Steuhl

Meller

2017

Klin Monatsbl Augenheilkd

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Limbal stem cell deficiency (LSCD) is a condition caused by the loss of corneal epithelial regenerative potential. The treatment of this condition is still a challenge. It results from various conditions both intrinsic as well as extrinsic. LSCD can be either uni- or bilateral and either partial or total. Today treatment options include a variety of techniques including transplantation of amniotic membrane and limbal tissue or tissue engineered cell sheets. This article summarizes the current techniques to treat LSCD and upcoming developments.

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“…Presently, there are three keratoprosthesis with a widespread use in humans: the Boston keratoprosthesis (B-KPro) [ 9 , 10 ], the osteo-odonto-keratoprosthesis (OOKP) [ 11 , 12 , 13 ], and the so-called MICOF (Moscow eye microsurgery complex in Russia) [ 14 , 15 ]. Likewise, newer designs are recently strongly emerging, such as the KeraKlear ® (Keramed) [ 16 , 17 ], the Miro Cornea ® [ 17 , 18 ], and the Alphacor [ 19 , 20 ]. However, while the first two have presented promising initial results despite a very short follow up, the latter has been recently discontinued after developing severe mid- and long-term complications.…”

Section: Introductionmentioning

confidence: 99%

Keratoprosthesis: A Review of Recent Advances in the Field

Salvador-Culla

Kolovou

2016

JFB

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Since its discovery in the years of the French Revolution, the field of keratoprostheses has evolved significantly. However, the path towards its present state has not always been an easy one. Initially discarded for its devastating complications, the introduction of new materials and the discovery of antibiotics in the last century gave new life to the field. Since then, the use of keratoprostheses for severe ocular surface disorders and corneal opacities has increased significantly, to the point that it has become a standard procedure for corneal specialists worldwide. Although the rate of complications has significantly been reduced, these can impede the long-term success, since some of them can be visually devastating. In an attempt to overcome these complications, researchers in the field have been recently working on improving the design of the currently available devices, by introducing the use of new materials that are more biocompatible with the eye. Here we present an update on the most recent research in the field.

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Aktuelle Versorgungsmöglichkeiten mit Keratoprothesen

Abstract: Keratoprostheses, such as the Boston Kpro and OOKP are valid treatment options for eyes which are not open to therapy with allogeneic corneal transplantation. Modern implants such as KeraKlear® prosthesis and Miro Cornea® need further prospective clinical evaluation.

Cited by 27 publications

References 27 publications

Plant Recombinant Human Collagen Type I Hydrogels for Corneal Regeneration

Plant Recombinant Human Collagen Type I Hydrogels for Corneal Regeneration

Optische Rehabilitation nach Limbusstammzellinsuffizienz: aktuelle Behandlungsmöglichkeiten und Entwicklungen

Keratoprosthesis: A Review of Recent Advances in the Field

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