Corneal replacement using a synthetic hydrogel cornea, AlphaCor™: device, preliminary outcomes and complications

Hicks, C.R.; Crawford, Gemma; Lou, Xia; Tan, Donald; Snibson, Grant R.; Sutton, Gerard; Downie, Nicholas; Werner, Liliana; Chirila, T.V.; Constable, Ian J.

doi:10.1038/sj.eye.6700333

Cited by 128 publications

(76 citation statements)

References 5 publications

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“…Over time, the polymer is hydrolyzed resulting in erosion of the matrix. [8] These PHEMA hydrogels have been shown to be useful for cell immobilization, [9][10][11] coating drug delivery devices for neural micro-electrode arrays, [12] artificial skin, [13] corneal replacements and repairs, [6,14] controlled drug release, [15] and as synthetic articular cartilage. [16,17] Understanding the degradation of PHEMA films is important because both porosity and hydrogel formation depend on how the film degrades over time.…”

Section: Introductionmentioning

confidence: 99%

Cross‐Linking and Degradation Properties of Plasma Enhanced Chemical Vapor Deposited Poly(2‐hydroxyethyl methacrylate)

Pfluger

Carrier

Sun

et al. 2009

Macromol. Rapid Commun.

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Plasma Enhanced Chemical Vapor Deposition (PECVD) of poly-2-hydroxyethyl methacrylate (pHEMA) biocompatible, biodegradable polymer films were produced alone and cross-linked with ethylene glycol diacrylate (EGDA). Degree of cross-linking was controlled via manipulation of the EGDA flow rate, which influenced the amount of swelling and the extent of degradation of the films in an aqueous solution over time. Noncross-linked pHEMA films swelled 10% more than cross-linked films after 24 h of incubation in an aqueous environment. Increasing degree of film cross-linking decreased degradation over time. Thus, PECVD pHEMA films with variable cross-linking properties enable tuning of gel formation and degradation properties, making these films useful in a variety of biologically significant applications.

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Section: Introductionmentioning

confidence: 99%

Cross‐Linking and Degradation Properties of Plasma Enhanced Chemical Vapor Deposited Poly(2‐hydroxyethyl methacrylate)

Pfluger

Carrier

Sun

et al. 2009

Macromol. Rapid Commun.

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“…1 In such circumstances, the use of an artificial cornea, or keratoprosthesis (Kpro), plays a significant role in providing visual rehabilitation. Many Kpro devices have been developed over the past decades, including AlphaCor, 2,3 Boston Keratoprosthesis (Boston Kpro), 4 osteo-odonto keratoprosthesis (OOKP), 5 and the Moscow Eye Microsurgery Complex in Russia (MICOF) keratoprosthesis. 6,7 The Boston Kpro and OOKP, the most commonly used Kpros, have been used to treat patients with multiple graft failures, aniridia, chemical injuries, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, and thermal burns as well as other conditions with high risk of corneal graft rejection and failure.…”

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confidence: 99%

Application of Graphene as Candidate Biomaterial for Synthetic Keratoprosthesis Skirt

Tan

Thompson

Konstantopoulos

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Synthetic keratoprostheses are required for visual rehabilitation in patients with endstage corneal blindness. This study aimed to assess the biocompatibility of graphene material and its potential as a novel synthetic keratoprosthesis skirt material for corneal tissue engineering. METHODS.Human corneal stromal fibroblasts were cultured on material surfaces including pristine graphene film, graphene foam, pristine titanium (Ti) discs, and tissue culture plastic surface (TCPS). Cell attachment was assayed by immunostaining of paxillin and vinculin. Cell viability and proliferation were assessed by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and Click iT 5-ethynyl-2 0 -deoxyuridine (EdU) assays. The growth of fibroblasts on three-dimensional graphene foam was examined by scanning electron microscopy, and cytokine release was analyzed by enzyme-linked immunosorbent assay. Graphene films were implanted into rabbit corneal stromal pockets and examined by slit-lamp biomicroscopy, anterior segment optical coherence tomography, in vivo confocal microscopy, and histology.RESULTS. Pristine graphene demonstrated good biocompatibility with human stromal fibroblasts in terms of cell adhesion, viability, and proliferation. Cells on graphene films showed higher number than on TCPS control. Cells grown on graphene had 10% more proliferation than on Ti. The expression levels of IL-6 and IL-8 were reduced when cells were seeded on graphene foam as compared to Ti and graphene film. Implantation of graphene film into rabbit stroma (n ¼ 6) did not show any signs of infection, neovascularization, or inflammation.CONCLUSIONS. Graphene displayed excellent short-term biocompatibility with corneal cells and tissue. This demonstrates that graphene can be developed as a tissue engineering material for use in cornea.

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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%

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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Corneal replacement using a synthetic hydrogel cornea, AlphaCor™: device, preliminary outcomes and complications

Cited by 128 publications

References 5 publications

Cross‐Linking and Degradation Properties of Plasma Enhanced Chemical Vapor Deposited Poly(2‐hydroxyethyl methacrylate)

Cross‐Linking and Degradation Properties of Plasma Enhanced Chemical Vapor Deposited Poly(2‐hydroxyethyl methacrylate)

Application of Graphene as Candidate Biomaterial for Synthetic Keratoprosthesis Skirt

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

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Corneal replacement using a synthetic hydrogel cornea, AlphaCor™: device, preliminary outcomes and complications

Cited by 128 publications

References 5 publications

Cross‐Linking and Degradation Properties of Plasma Enhanced Chemical Vapor Deposited Poly(2‐hydroxyethyl methacrylate)

Cross‐Linking and Degradation Properties of Plasma Enhanced Chemical Vapor Deposited Poly(2‐hydroxyethyl methacrylate)

Application of Graphene as Candidate Biomaterial for Synthetic Keratoprosthesis Skirt

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