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Corneal Cell and Nerve Regeneration promoted by Biosynthetic Implants
Author(s) -
LAGALI N,
GRIFFITH M,
FAGERHOLM P
Publication year - 2011
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2011.3474.x
Subject(s) - cornea , stromal cell , regeneration (biology) , anatomy , pathology , stroma , medicine , chemistry , ophthalmology , biology , microbiology and biotechnology , immunohistochemistry
Purpose To assess cell, nerve, and stromal regeneration in a biosynthetic material 3 years after implantation into human corneas, and compare results to human donor corneas. Methods 10 patients received biosynthetic implants, and 10 received human donor corneas. At 12, 24, and 36 months postoperatively, slit lamp, anterior segment optical coherence tomography (ASOCT), contact esthesiometry, and in vivo confocal microscopy (IVCM) examinations were performed. Results Thickness remained stable in biosynthetic corneas, while swelling was observed in donor material. Reduced transparency was apparent at graft borders in all corneas, while clear central corneas were observed in all donor corneas and in some biosynthetic corneas at 3 years. At the cellular level, biosynthetic material was incompletely populated by keratocytes after 3 years, while human tissue contained keratocytes and features indicative of stromal cell death, not seen in biosynthetic implants. Only partial touch sensitivity was restored in both groups after three years, corresponding to slow subbasal nerve recovery. Nerve regeneration into the central cornea was apparently impeded by peripheral interface scar tissue in all corneas. The epithelial‐to‐stromal transition was uneven in biosynthetic implants, while epithelium overlying human donor tissue often contained dendritic inflammatory cells. Conclusion No cornea resembled a native cornea at 3 years. Nerve and sensitivity restoration were incomplete, and scar tissue was stable over the long term. Keratocytes slowly populated the biomaterial, and keratocyte death was common in human donor tissue. Only human donor corneas exhibited signs of an immune response at the microscopic level.