"Epithelialization of the plastic front plate of the Boston keratoprosthesis is of clinical significance in that it potentially represents a further step towards the desired goal of bio-integration of the device . Current recommendations for Boston keratoprosthesis patients include prophylactic topical antibiotics for life to minimize the risk of endophthalmitis [2, 14, 19, 20]. "
[Show abstract][Hide abstract] ABSTRACT: The aim of this work is to characterize a transparent tissue layer partially covering the anterior surface of the type I Boston permanent keratoprosthesis front plate in four patients.
The tissue over the front plate was easily scrolled back as a single transparent layer using a sponge. In two cases, histopathologic analysis was undertaken and immunofluorescent staining with a cytokeratin 3-specific antibody was performed. The relationship of the tissue to the keratoprosthesis device was further characterized using spectral domain high-definition optical coherence tomography (HD-OCT).
Histopathologic analysis revealed the tissue to be non-keratinized squamous epithelium. No goblet cells were seen, suggesting the cells were of corneal, and not conjunctival, epithelial origin. Immunofluorescent staining of all cells was positive for cytokeratin 3, a protein strongly associated with corneal epithelium. The tissue was easily discerned by HD-OCT and was of substantial thickness near the external junction between the keratoprosthesis device and the carrier corneal tissue. In three cases, visual acuity was unaffected by the presence or absence of this tissue. In one case, a prominent tissue margin temporarily obscured the visual axis and reduced visual acuity; this resolved with mechanical central debridement and has not recurred.
The transparent tissue layer covering the anterior surface of the type I Boston keratoprosthesis front plate was found to represent non-keratinized squamous epithelium, most likely of corneal epithelial origin. This potentially represents a further step in bio-integration of the keratoprosthesis device. In particular, epithelial coverage of the critical junction between the device and the carrier corneal tissue might serve an important barrier function and further reduce the incidence of infection and extrusion of the type I Boston permanent keratoprosthesis.
Albrecht von Graæes Archiv für Ophthalmologie 02/2012; 250(8):1195-9. DOI:10.1007/s00417-012-1960-5 · 1.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Glaucoma drainage devices are more frequently being used for glaucoma filtering surgeries, even those at low risk for failure with trabeculectomy. There are 4 major devices available: the Molteno, Baerveldt, Krupin, and Ahmed. The Molteno and Baerveldt are non-valved implants, while the Krupin and Ahmed are valved. The success rates of the different valves are about equal at approximately 70% with a mean intraocular pressure (IOP) lowering of at least 50% from the pre-operative IOP. Unfortunately, the failure rate is about 10% per year, leading to only 50% functional drainage devices at 5 years. Therefore, research on the biomaterials, shape, and technique of drainage implant surgery is being done in hopes of increasing long term success rates.
Seminars in ophthalmology 11/2010; 25(5-6):265-70. DOI:10.3109/08820538.2010.518840 · 0.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In the present study, novel biomimetic composite scaffolds with a composition similar to that of natural bone were prepared, using nano-hydroxyapatite, collagen, and phosphatidylserine. The scaffolds possess an interconnected porous structure with a porosity of 84%. The pore size ranges from several micrometers up to about 400 μm. In-vitro studies in simulated body fluids showed that the morphologies of the products derived from mineralization can be regulated by the extracellular matrix components of the scaffolds; this in turn leads to creation of a large number of hydroxyapatite crystals on the scaffold surface. The regulatory properties of collagen and phosphatidylserine also influenced the cell response to the composite scaffolds. MC3T3-E1 cells attached and spread on the surfaces of the materials and interacted with the substrates; this may be the result of charged groups on the composite materials. Radiological analysis suggested that calluses and bone bridges formed in defects within 12 weeks. These composite scaffolds may therefore be a suitable replacement in bone-tissue engineering.
Chinese Science Bulletin 07/2012; 57(21). DOI:10.1007/s11434-012-5201-4 · 1.58 Impact Factor
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