AlphaCor™ keratoprosthesis: postoperative development of six patients

Holak, Sophie; Holak, Heinrich; Bleckmann, H.

doi:10.1007/s00417-008-0964-7

Cited by 21 publications

(12 citation statements)

References 18 publications

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“…These keratoprostheses have enjoyed some success, with the Boston keratoprosthesis being placed in over 1000 patients in 2009 (Gomaa et al , 2010). Another device that initially gave promising results was the AlphaCor (Bleckmann and Holak 2006; Hicks et al , 2006), although recent reports have been less encouraging (Chalam et al , 2007; Holak et al , 2009). As an alternative to the use of plastics, several investigations have been made to engineer an artificial cornea using natural compounds, such as collagens, cells and cell lines (Alaminos et al , 2006; Fagerholm et al , 2009; Gonzalez‐Andrades et al , 2009; Huang and Li 2007; Mi et al , 2010; Schneider et al , 1999; Vrana et al , 2008).…”

Section: Discussionmentioning

confidence: 99%

Transforming growth factor-β3 regulates assembly of a non-fibrotic matrix in a 3D corneal model

Karamichos

Hutcheon

Zieske

2011

J Tissue Eng Regen Med

104

140

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Purpose Corneal tissue engineering has attracted the attention of many researchers over the years in part due to the cornea’s avascularity and relatively, straight forward structure. However, the highly organized and structured nature of this optically clear tissue has presented a great challenge. We have previously developed a model where human corneal fibroblasts (HCFs) are stimulated by a stable Vitamin C (VitC) derivative to self-assemble an extracellular matrix (ECM). Addition of TGF-β1 enhanced the assembly of ECM; however, it was accompanied by the upregulation of specific fibrotic markers. In this study, we tested the effects of all three TGF-β isoforms (-β1, -β2 and -β3) on ECM production, as well as, expression of fibrotic markers. Methods HCFs were grown in four media conditions for 4 weeks: (Control) VitC only; (T1) VitC+TGF-β1; (T2) VitC+TGF-β2; or (T3) VitC+TGF-β3. Cultures were analyzed with Western Blots, TEM and indirect-immunofluorescence (IF). Results Compared to controls, all TGF-β isoforms stimulated matrix production by ~3 times. IF showed the presence of type III collagen and smooth muscle actin (SMA) in T1 and T2; however, T3 showed little, to no, expression. In western blots, T3 stimulated a lower type III/type I collagen ratio when compared to the other conditions. In addition, TEM indicated that T3 stimulated a higher level of matrix alignment and organization. Conclusions HCFs stimulated by VitC and TGF-β3 appear to generate a matrix that mimics the normal adult or developing human cornea; whereas, TGF-β1 and -β2 are driving the constructs toward a more fibrotic path.

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Section: Discussionmentioning

confidence: 99%

Transforming growth factor-β3 regulates assembly of a non-fibrotic matrix in a 3D corneal model

Karamichos

Hutcheon

Zieske

2011

J Tissue Eng Regen Med

104

140

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“…Among them, Boston keratoprosthesis type 1 and 2, the AlphaCor artificial cornea, the Legeais BioKpro III and the osteo-odonto Keratoprosthesis represent the commonest forms [2,7,8]. Although Kpro has gained supporters over the last decade, the management of post-operative complications, especially when posterior segment approach is indicated, remains a challenge [9].…”

Section: Discussionmentioning

confidence: 98%

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Georgalas

Kanelopoulos

Petrou

et al. 2009

Graefes Arch Clin Exp Ophthalmol

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We present our experience from managing presumed bacterial endophthalmitis with 25 g PPV in patients previously implanted with Boston Kpro, which to the best of our knowledge has not been reported before. Although the number of cases is small to draw accurate conclusions, we have to report that 25 g vitrectomy was performed without significant difficulties and seems to be a useful tool for the management of patients with Kpros requiring vitreoretinal surgery.

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“…Although several models of KPros have been designed for clinical use, few models have received FDA approval and are currently on the market. 15,28 The most critical problem of clinically approved KPros is bioincompatibility, followed by extrusion, glucoma, and endophthalmitis. Improvements in the design and materials of KPros are therefore necessary to increase tissue biointegration and biocompatibility and to prevent extrusion.…”

Section: Discussionmentioning

confidence: 99%

“…Both parts are made from poly-2-hydroxyethyl methacrylate. 14,15 However, the development of inexpensive and biocompatible materials that can be manufactured using novel and simple techniques is necessary to further improve the biocompatibility of artificial corneas.…”

Section: Introductionmentioning

confidence: 99%

Poly (ε-caprolactone) nanofibrous ring surrounding a polyvinyl alcohol hydrogel for the development of a biocompatible two-part artificial cornea

Bakhshandeh¹,

Soleimani²,

Hosseini³

et al. 2011

IJN

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The study aimed to fabricate and characterize a 2-part artificial cornea as a substitute for penetrating keratoplasty in patients with corneal blindness. The peripheral part of the artificial cornea consisted of plasma-treated electrospun poly (ɛ-caprolactone) (PCL) nanofibers, which were attached to a hydrogel disc of polyvinyl alcohol (PVA) as a central optical part. The physical properties of the prepared artificial cornea, including morphology, mechanical properties, light transmittance, and contact angle, were assessed. Cell attachment and proliferation studies were performed on rabbit limbal stem cells. The SEM image of the polymeric system showed that the peripheral part formed a highly porous scaffold that could facilitate tissue biointegration. Assessment of the mechanical properties of the peripheral nanofibrous part and the hydrogel optical part showed suitable elasticity. Young’s modulus values of the electrospun PCL skirt and PVA hydrogel core were 7.5 and 5.3 MPa, respectively, which is in line with the elasticity range of natural human cornea (0.3–7 MPa). The light transmittance of the central part was >85% when measured in the 400–800 nm wavelength range. The plasma-treated PCL nanofibrous scaffold promoted limbal stem cell adhesion and proliferation within 10 days. These results confirmed that the polymeric artificial cornea showed suitable physical properties and good biocompatibility and epithelialization ability.

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AlphaCor™ keratoprosthesis: postoperative development of six patients

Abstract: Further evaluation is needed to evaluate the role of AlphaCor as a keratoprosthesis.

Cited by 21 publications

References 18 publications

Transforming growth factor-β3 regulates assembly of a non-fibrotic matrix in a 3D corneal model

Transforming growth factor-β3 regulates assembly of a non-fibrotic matrix in a 3D corneal model

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Poly (ε-caprolactone) nanofibrous ring surrounding a polyvinyl alcohol hydrogel for the development of a biocompatible two-part artificial cornea

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AlphaCor™ keratoprosthesis: postoperative development of six patients

Abstract: Further evaluation is needed to evaluate the role of AlphaCor as a keratoprosthesis.

Cited by 21 publications

References 18 publications

Transforming growth factor-β3 regulates assembly of a non-fibrotic matrix in a 3D corneal model

Transforming growth factor-β3 regulates assembly of a non-fibrotic matrix in a 3D corneal model

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Poly (&epsilon;-caprolactone) nanofibrous ring surrounding a polyvinyl alcohol hydrogel for the development of a biocompatible two-part artificial cornea

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Product

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Poly (ε-caprolactone) nanofibrous ring surrounding a polyvinyl alcohol hydrogel for the development of a biocompatible two-part artificial cornea