Development of Contact Lens-Shaped Crosslinked Amniotic Membranes for Sutureless Fixation in the Treatment of Ocular Surface Diseases

Abstract

To develop a new method of manufacturing contact lens-shaped crosslinked amniotic membranes (AMs) using glutaraldehyde (GA) and dialdehyde starch (DAS) as crosslinking agents. Methods: Amniotic membranes were placed on a curved plastic mold and crosslinked with either 4.5% DAS or 1% GA, after which their physical properties and biological safety were evaluated. Results: The tensile strength of the GA-and DAS-crosslinked samples was much increased compared with that of normal AMs. Neither crosslinking process affected AM transparency. Although the GA-crosslinked AM showed better enzymatic resistance, its physiological structure was severely damaged after the crosslinking process. On the other hand, compared with the GA-crosslinked AM, the DAS-crosslinked AM showed higher growth factor concentrations and better biocompatibility, similar to normal AMs. In addition, the DAS-crosslinked AM was effective in the recovery of corneal epithelial wounds and was well maintained over 3 days without decentration or degradation on the ocular surface in human subjects. Conclusions: Contact lens-shaped AMs were successfully prepared with crosslinking agents. Crosslinking with DAS did not affect the structural properties or biological activity of the AMs, and the improved mechanical properties helped the AM to maintain its curved shape. This crosslinking method allowed us to transplant AMs into patients' eyes without sutures. Translational Relevance: Sutureless fixation of contact lens-shaped AMs would be very convenient and safe for the treatment of corneal surface disease.

Application of Noggin-Coated Electrospun Scaffold in Corneal Wound Healing

“…These results indicate that fabricated scaffolds possess better or similar mechanical properties than amniotic membranes or commercially available contact lenses used in corneal wound healing. 41 – 43 …”

“…This scaffold (52.305 ± 6.130 MPa) has a higher stiffness than commercially available soft contact lenses (0.3–0.6 MPa) and comparable stiffness to crosslinked amniotic membranes (46.5 ± 9.8 MPa). 41 – 43 …”

Sutureless Amniotic Membrane Transplantation in Inflammatory Corneal Perforations

“…Other SAMT-reported procedures include mounting the amniotic membrane on an ocular conformer [37] or directly on a contact lens [38]. Yi et al managed to prepare a contact lens-shaped AM using glutaraldehyde and dialdehyde starch as a cross-linking agent [39]. The literature reports the use of a self-retaining cryopreserved amniotic membrane (PROKERA ® Slim, Bio-Tissue, Miami, FL, USA) for the treatment of dry eye disease [40], corneal ulcers [41], Stevens-Johnson syndrome/toxic epidermal necrolysis [42], and Sjögren's syndrome [43].…”

Feasibility study of oxidized naringin as a novel crosslinking agent for crosslinking decellularized porcine Achilles tendon and its potential application for anterior cruciate ligament repair

“…Fixation is a chemical modification of immobilizing and crosslinking decellularized materials by blocking the binding site of collagenase 16 . At present, a variety of crosslinking reagents have been developed to fix tissues, such as glutaraldehyde (GA), 17 genipin, 18,19 and so forth. Although it can improve the stability of biological tissues, they have many problems in practical applications 20 .…”