Retrocorneal Membrane After Descemet Membrane Endothelial Keratoplasty

Yum, Hae Ri; Kim, Man Soo; Kim, Eun Chul

doi:10.1097/ico.0b013e318296e0f7

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…Although wound healing in the wall of the heart is clearly a desirable outcome, wound healing in the cornea may have deleterious functional effects if it causes opacification, and more so when this is accompanied by inflammation. This particularly affects wound healing in association with surgical implants and prostheses as applied to the cornea where the major complication is the formation of RCM (Hicks & Hamilton, ; Obata & Tsuru, ; Yum et al, ). These are, in effect, opaque fibrotic capsules (Küchle & Green, ) that surround the corneal implant (Bakhtiari et al, ; Hicks & Hamilton, ) and obstruct the transmission of light.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, full thickness implants, where the integrity of host endothelium is compromised, depend upon minimising the wound healing response and development of opaque scar tissue (retro‐corneal membrane [RCM] formation) to retain transparency. Accordingly, lamellar implants have enjoyed some degree of success (P. Fagerholm et al, ; Islam et al, ; Jangamreddy et al, ), whereas full thickness implants do not remain clear due to RCM formation in many cases (Hicks & Hamilton, ; Obata & Tsuru, ; Rajendran, Netuková, Griffith, Forrester, & Kuffová, ; Yum, Kim, & Kim, ). However, they can function as tectonic grafts allowing preservation of the eye in the case of a nonhealing wound and later replacement with a full thickness, endothelium‐intact, penetrating allograft.…”

Section: Introductionmentioning

confidence: 99%

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Activation of dendritic cells by crosslinked collagen hydrogels (artificial corneas) varies with their composition

Moelzer¹,

Shankar

Griffith

et al. 2019

J Tissue Eng Regen Med

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Activated T cells are known to promote fibrosis, a major complication limiting the range of polymeric hydrogels as artificial corneal implants. As T cells are activated by dendritic cells (DC), minimally activating hydrogels would be optimal. In this study, we evaluated the ability of a series of engineered (manufactured/fabricated) and natural collagen matrices to either activate DC or conversely induce DC apoptosis in vitro. Bone marrow DC were cultured on a series of singly and doubly crosslinked hydrogels (made from recombinant human collagen III [RHCIII] or collagen mimetic peptide [CMP]) or on natural collagen‐containing matrices, MatrigelTM and de‐cellularised mouse corneal stroma. DC surface expression of major histocompatibility complex Class II and CD86 as well as apoptosis markers were examined. Natural matrices induced low levels of DC activation and maintained a “tolerogenic” phenotype. The same applied to singly crosslinked CMP‐PEG gels. RHCIII gels singly crosslinked using either N‐(3‐dimethylaminopropyl)‐N′‐ethylcarbodiimide with the coinitiator N‐hydroxy succinimide (EDC‐NHS) or N‐cyclohexyl‐N‐(2‐morpholinoethyl)carbodiimide metho‐p‐toulenesulfonate with NHS (CMC‐NHS) induced varying levels of DC activation. In contrast, however, RHCIII hydrogels incorporating an additional polymeric network of 2‐methacryloyloxyethyl phosphorylcholine did not activate DC but instead induced DC apoptosis, a phenomenon observed in natural matrices. This correlated with increased DC expression of leukocyte‐associated immunoglobulin‐like receptor‐1. Despite low immunogenic potential, viable tolerogenic DC migrated into and through both natural and manufactured RHCIII gels. These data show that the immunogenic potential of RHCIII gels varies with the nature and composition of the gel. Preclinical evaluation of hydrogel immunogenic/fibrogenic potential is recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Activation of dendritic cells by crosslinked collagen hydrogels (artificial corneas) varies with their composition

Moelzer¹,

Shankar

Griffith

et al. 2019

J Tissue Eng Regen Med

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“…Long-term follow-up showed a high incidence of posterior stromal and graft interface haze 42 , 43 . Aside from this, the retrocorneal membrane can develop postoperatively in cases with dislocation or detachment of Descemet’s membrane endothelial graft 44 . We presume that these complications are connected to the DM removal and the exposure of the corneal stroma to the aqueous humor.…”

Section: Discussionmentioning

confidence: 99%

Descemet’s Membrane Supports Corneal Endothelial Cell Regeneration in Rabbits

Chen

Zhang

et al. 2017

Sci Rep

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Descemet’s membrane (DM) helps maintain phenotype and function of corneal endothelial cells under physiological conditions, while little is known about the function of DM in corneal endothelial wound healing process. In the current study, we performed in vivo rabbit corneal endothelial cell (CEC) injury via CEC scraping, in which DM remained intact after CECs removal, or via DM stripping, in which DM was removed together with CECs. We found rabbit corneas in the CEC scraping group healed with transparency restoration, while there was posterior fibrosis tissue formation in the corneas after DM stripping on day 14. Following CEC scraping on day 3, cells that had migrated toward the central cornea underwent a transient fibrotic endothelial-mesenchymal transition (EMT) which was reversed back to an endothelial phenotype on day 14. However, in the corneas injured via DM stripping, most of the cells in the posterior fibrosis tissue did not originate from the corneal endothelium, and they maintained fibroblastic phenotype on day 14. We concluded that corneal endothelial wound healing in rabbits has different outcomes depending upon the presence or absence of Descemet’s membrane. Descemet’s membrane supports corneal endothelial cell regeneration in rabbits after endothelial injury.

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“…After corneal allotransplantation, its development has been reported after failed penetrating keratoplasty (18), Descemet stripping endothelial keratoplasty (19,20), and Descemet membrane endothelial keratoplasty (21). The reported incidence varies considerably from 17% to 83% (22–24).…”

Section: Discussionmentioning

confidence: 99%

“…A retrocorneal membrane can develop as a complication after corneal allotransplantation, trauma, or infection (e.g., herpes simplex virus‐1 infection), if these insults affect the endothelium. After corneal allotransplantation, its development has been reported after failed penetrating keratoplasty, Descemet stripping endothelial keratoplasty, and Descemet membrane endothelial keratoplasty . The reported incidence varies considerably from 17% to 83% …”

Section: Discussionmentioning

confidence: 99%

Development of retrocorneal membrane following pig‐to‐monkey penetrating keratoplasty

Lee

Mammen

Dhaliwal

et al. 2016

Xenotransplantation

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Introduction Recent reports of long-term survival after wild-type (WT) pig-to-monkey corneal xenotransplantation are encouraging. We experienced the rapid development of retrocorneal membranes, a rare complication after corneal allotransplantation (though seen in infants and young children). The original specific aim of the study was to determine the factors associated with successful (young) pig corneal transplantation in monkeys. However, when it was obvious that retrocorneal membranes rapidly developed, our aims became to determine the factors involved in its development after both WT and GE pig corneal xenotransplantation and to investigate the characteristics of the retrocorneal membrane. Methods Rhesus monkeys were recipients of penetrating keratoplasty using WT and GE pigs (n=2, respectively, 1–3 months-old). Local/systemic steroids were administered for 3 months. Grafts were evaluated by slit-lamp for corneal transparency, edema, and neovascularization. Hematoxylin and eosin, Masson trichrome staining, and immunohistochemical analysis were performed. Gal staining was also carried out to distinguish the origin of the membrane. Results All penetrating keratoplasty recipients developed fibrous retrocorneal membranes in the early post-transplantation period, regardless of whether the graft was from a WT or GE pig. There were no features of rejection, with no cell infiltrate in the graft or anterior chamber during the 3 months follow-up. There was no difference in the clinical course between the two groups (WT or GE corneas). Immunohistochemistry indicated that the retrocorneal membranes were CK-negative, α-SMA-positive, and vimentin-positive, suggesting that they were of fibrous (keratocytic) origin. Also, the membrane was Gal positive, suggesting that it is derived from pig cornea. Conclusions Following pig-to-monkey corneal xenotransplantation, we report that retrocorneal membranes are derived from donor pig keratocytes. Prevention of retrocorneal membranes will be necessary to achieve successful corneal xenotransplantation.

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Retrocorneal Membrane After Descemet Membrane Endothelial Keratoplasty

Abstract: We report the first case of retrocorneal membrane formation after DMEK surgery.

Cited by 14 publications

References 14 publications

Activation of dendritic cells by crosslinked collagen hydrogels (artificial corneas) varies with their composition

Activation of dendritic cells by crosslinked collagen hydrogels (artificial corneas) varies with their composition

Descemet’s Membrane Supports Corneal Endothelial Cell Regeneration in Rabbits

Development of retrocorneal membrane following pig‐to‐monkey penetrating keratoplasty

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