Ten-year follow-up of epikeratophakia for the correction of high myopia

Kaminski, S.; Biowski, Robert; Koyuncu, Didem; Lukas, Julius; Grabner, Günther

doi:10.1016/s0161-6420(03)00827-3

“…Here, traditional allografts containing donor cells were used, as is the case of human corneal transplantations that the implants are designed to replace. This corresponds to reports where nerve in-growth and touch sensitivity recovers slowly (Ͼ18 mo after laser refractive eye surgery; Ͼ10 yr after LKP) after human corneal wounding or transplantation (33,34). Our result, therefore, represents a dramatic advance over the slow nerve regeneration after current human donor allograft therapy (34) and a demonstration of in vivo nerve regeneration in the cornea promoted by a fabricated material.…”

Section: Discussionsupporting

confidence: 86%

“…In addition, such corneal implants could circumvent potential problems resulting from the lack of nerve regeneration after surgery, found both in human donor tissue (34,35) and in other proposed, fully synthetic, or acylated collagen implants (5,36). These biosynthetic matrices with bound cell adhesion factors may have implications for the general field of tissue engineering, especially for the challenging problem of nerve regeneration and the innervation of other engineered organ and tissue systems.…”

Section: Discussionmentioning

confidence: 99%

Cellular and nerve regeneration within a biosynthetic extracellular matrix for corneal transplantation

Li¹,

Carlsson²,

Lohmann³

et al. 2004

American Journal of Ophthalmology

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Our objective was to determine whether key properties of extracellular matrix (ECM) macromolecules can be replicated within tissue-engineered biosynthetic matrices to influence cellular properties and behavior. To achieve this, hydrated collagen and Nisopropylacrylamide copolymer-based ECMs were fabricated and tested on a corneal model. The structural and immunological simplicity of the cornea and importance of its extensive innervation for optimal functioning makes it an ideal test model. In addition, corneal failure is a clinically significant problem. Matrices were therefore designed to have the optical clarity and the proper dimensions, curvature, and biomechanical properties for use as corneal tissue replacements in transplantation. In vitro studies demonstrated that grafting of the laminin adhesion pentapeptide motif, YIGSR, to the hydrogels promoted epithelial stratification and neurite in-growth. Implants into pigs' corneas demonstrated successful in vivo regeneration of host corneal epithelium, stroma, and nerves. In particular, functional nerves were observed to rapidly regenerate in implants. By comparison, nerve regeneration in allograft controls was too slow to be observed during the experimental period, consistent with the behavior of human cornea transplants. Other corneal substitutes have been produced and tested, but here we report an implantable matrix that performs as a physiologically functional tissue substitute and not simply as a prosthetic device. These biosynthetic ECM replacements should have applicability to many areas of tissue engineering and regenerative medicine, especially where nerve function is required.regenerative medicine ͉ tissue engineering ͉ cornea ͉ implantation ͉ innervation

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“…The epikeratophakia technique involved the removal of host corneal epithelium and fixation by suture of a cryolathed donor corneal lenticule on to the anterior stroma, over which the host epithelium would heal. 25,26 The failure to widely adopt this technique resulted from a number of postoperative complications including interface scarring between the lenticule and host cornea, and poorly predictable astigmatic outcomes. In contrast to these methods, the technique of refractive stromal lenticule re-implantation described here clearly has significant advantages in terms of lamellar accuracy and refractive correction.…”

Section: Discussionmentioning

confidence: 99%

Refractive Lenticule Re-Implantation after Myopic ReLEx: A Feasibility Study of Stromal Restoration after Refractive Surgery in a Rabbit Model

Angunawela

¹

,

Riau

²

,

Chaurasia

³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…Overall, we can now control the strength and optical clarity of noncytotoxic, biosynthetic composites to the point that TE corneal replacements may, ultimately, address future world shortages of donor corneas. In addition, such corneal implants could circumvent potential problems resulting from the lack of nerve regeneration after surgery, found both in human donor tissue (34,35) and in other proposed, fully synthetic, or acylated collagen implants (5,36). These biosynthetic matrices with bound cell adhesion factors may have implications for the general field of tissue engineering, especially for the challenging problem of nerve regeneration and the innervation of other engineered organ and tissue systems.…”

Section: Discussionmentioning

confidence: 99%

Cellular and nerve regeneration within a biosynthetic extracellular matrix for corneal transplantation

Li

¹

,

Carlsson²,

Lohmann³

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Our objective was to determine whether key properties of extracellular matrix (ECM) macromolecules can be replicated within tissue-engineered biosynthetic matrices to influence cellular properties and behavior. To achieve this, hydrated collagen and Nisopropylacrylamide copolymer-based ECMs were fabricated and tested on a corneal model. The structural and immunological simplicity of the cornea and importance of its extensive innervation for optimal functioning makes it an ideal test model. In addition, corneal failure is a clinically significant problem. Matrices were therefore designed to have the optical clarity and the proper dimensions, curvature, and biomechanical properties for use as corneal tissue replacements in transplantation. In vitro studies demonstrated that grafting of the laminin adhesion pentapeptide motif, YIGSR, to the hydrogels promoted epithelial stratification and neurite in-growth. Implants into pigs' corneas demonstrated successful in vivo regeneration of host corneal epithelium, stroma, and nerves. In particular, functional nerves were observed to rapidly regenerate in implants. By comparison, nerve regeneration in allograft controls was too slow to be observed during the experimental period, consistent with the behavior of human cornea transplants. Other corneal substitutes have been produced and tested, but here we report an implantable matrix that performs as a physiologically functional tissue substitute and not simply as a prosthetic device. These biosynthetic ECM replacements should have applicability to many areas of tissue engineering and regenerative medicine, especially where nerve function is required.regenerative medicine ͉ tissue engineering ͉ cornea ͉ implantation ͉ innervation

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Ten-year follow-up of epikeratophakia for the correction of high myopia

Cited by 15 publications

References 29 publications

Cellular and nerve regeneration within a biosynthetic extracellular matrix for corneal transplantation

Cellular and nerve regeneration within a biosynthetic extracellular matrix for corneal transplantation

Refractive Lenticule Re-Implantation after Myopic ReLEx: A Feasibility Study of Stromal Restoration after Refractive Surgery in a Rabbit Model

Cellular and nerve regeneration within a biosynthetic extracellular matrix for corneal transplantation

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