Opacification, Vascularization, and Chronic Inflammation Produced by Hydrogel Corneal Lamellar Implants

Ohrloff, C.; Duffin, R. Michael; Apple, David J.; Olson, Randall J.

doi:10.1016/0002-9394(84)90123-5

Cited by 15 publications

(2 citation statements)

References 8 publications

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“…A central opening above the KPro optics could then be performed following integration of the conjunctiva, similar to the procedure proposed for the AlphaCor. 18 The material itself was tolerated very well by the host tissue, and a toxic reaction, as previously reported for other polymers, 26 could not be detected.Biocompatibilityofthesoftpolymersusedinthisstudy was tested in an earlier study. 27 Small disks of the materials implanted in intrastromal pockets demonstrated some cellular reactions at the sites of mechanical stress, but no major cellular reaction against the implant material itself could be detected.…”

Section: Commentsupporting

confidence: 65%

Biological Response to a SupraDescemetic Synthetic Cornea in Rabbits

et al. 2004

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To evaluate the biocompatibility of a novel nonpenetrating keratoprosthesis (supraDescemetic synthetic cornea) in a rabbit model. Methods: Seven rabbits received a supraDescemetic synthetic cornea (7-mm diameter, 350-µm-thick optical zone, 100-µm-thick peripheral flange) in their healthy right eyes. A surgical technique was developed that allowed implantation of the device on top of the bare Descemet membrane. Three rabbits received a supraDescemetic synthetic cornea made of hydroxyethyl methacrylatemethyl methacrylate 26 , 1 received a hydroxyethyl methacrylate-N-vinyl pyrrolidone 75 mesoplant, and 3 were implanted with devices made of polymethyl methacrylate. All rabbits were euthanized after 8 weeks; the eyes were enucleated and examined by conventional histological and immunohistochemical evaluations. Results: All eyes became quiet within several days. The Des-cemet membrane remained transparent during the observation period. Indirect ophthalmoscopy performed through the prosthesis allowed accurate examination of the posterior pole. Histological evaluation of the implanted corneas displayed no signs of an acute or chronic inflammatory reaction to the supraDescemetic synthetic cornea in 5 eyes; a few inflammatory cells were detected in the corneas of 2 rabbits. The interface between the Descemet membrane and the mesoplant displayed ingrowth of very thin (Ͻ10-µm) tissues colonized by keratocytes in 3 of the 7 corneas. Conclusions: This study validates the biocompatibility of this new type of nonpenetrating keratoprosthesis. Because opening of the anterior chamber is not required with the supraDescemetic synthetic cornea, the risk for intraocular infection is minimal, and the implantation procedure is less traumatic compared with a penetrating device.

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Section: Commentsupporting

confidence: 65%

Biological Response to a SupraDescemetic Synthetic Cornea in Rabbits

et al. 2004

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“…However, serious complications were noted in some animal studies. 70 Some clinical studies noted some complications such as inlay migration, neovascularization apparently stimulated by the inlay or contaminants involving the inlay, "crystal formation" and haze surrounding the inlays, and epithelial ingrowth into the interfaces. There was one report of "crystalline" deposits surrounding 11 of 49 primate-implanted hydrogel inlays over a 4-year period, 71 which were similar to the crystals reported with 17 These turned out to be lipidoidal degenerative changes in the keratocytes.…”

Section: The Hydrogel Yearsmentioning

confidence: 98%

Intracorneal Inlays for the Correction of Ametropias

Binder

Li²,

Pol³

2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Various materials have been placed in the corneal stroma to modify a spherical refractive error (usually hyperopic). As the surgical procedures evolved to simplify the insertion process so has the quality and biocompatibility of the implanted materials. Failures have been due to excessive inlay dimensions, bioincompatibility of the materials used, poor choice of test model, or combinations of the above. We present a thorough analysis of the history of the intracorneal inlay and the materials and techniques used up to and including the current materials and techniques available for the correction of spherical refractive errors.

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Intracorneal Inlay Complicated by Intrastromal Epithelial Opacification

Alió¹

2004

Arch Ophthalmol

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To report epithelial perilenticular opacity as a new complication of intracorneal inlay implantation for the correction of hyperopia. Design: Prospective observational case series. Participants: Eleven eyes of 7 patients underwent intracorneal inlay implantation for the correction of hyperopia. Methods: Intracorneal inlays were implanted onto the stromal bed by using a microkeratome cut to create an inferior hinged corneal flap. Main Outcome Measures: Postoperative complication occurrence of intracorneal perilenticular opacity, microbiological laboratory analysis, histopathological analysis, and confocal microscopy study. Results: Of 11 implanted eyes, 5 showed diffuse perilenticular opacity of varying intensity that was unresponsive to steroid use following intracorneal inlay implantation. All patients had moderate to severe loss of best-corrected visual acuity. The inlays showed deposits at the edge and on the surface. Confocal microscopy in all eyes produced images compatible with the confocal morphologic features of epithelial cells. Explantation of inlays was performed in 5 eyes. The histopathologic study showed the presence of epithelial cells, and microbiological analysis and cultures were negative for bacteria, fungi, and mycobacteria. Conclusion: Epithelial perilenticular opacity is a new and serious complication in patients with intracorneal inlay implantation for the correction of hyperopia.

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Opacification, Vascularization, and Chronic Inflammation Produced by Hydrogel Corneal Lamellar Implants

Cited by 15 publications

References 8 publications

Biological Response to a SupraDescemetic Synthetic Cornea in Rabbits

Biological Response to a SupraDescemetic Synthetic Cornea in Rabbits

Intracorneal Inlays for the Correction of Ametropias

Intracorneal Inlay Complicated by Intrastromal Epithelial Opacification

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