June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Implantation of Biosynthetic Collagen III Corneal Implants in vivo in Rabbit Eyes: Surgical Technique and Clinical Performance
Author Affiliations & Notes
  • Karin Kobuch
    Ophthalmology, Technische Universität Muenchen, Klinikum rechts der Isar, Munich, Germany
  • Raphael Neuhann
    Ophthalmology, Technische Universität Muenchen, Klinikum rechts der Isar, Munich, Germany
  • Kerstin Wand
    Ophthalmology, Technische Universität Muenchen, Klinikum rechts der Isar, Munich, Germany
  • Johannes Junger
    MLase, Munich, Germany
  • Michael Baumann
    MLase, Munich, Germany
  • Roland Ritter
    Technolas PV, Munich, Germany
  • Mohammad Islam
    Regenerative Medicine, University of Linkoeping, Linkoeping, Sweden
  • May Griffith
    Regenerative Medicine, University of Linkoeping, Linkoeping, Sweden
  • Chris Lohmann
    Ophthalmology, Technische Universität Muenchen, Klinikum rechts der Isar, Munich, Germany
  • Footnotes
    Commercial Relationships Karin Kobuch, None; Raphael Neuhann, None; Kerstin Wand, None; Johannes Junger, MLase AG (E); Michael Baumann, None; Roland Ritter, Technolas Perfect Vision (E); Mohammad Islam, None; May Griffith, Univ. of Ottawa - OHRI (P); Chris Lohmann, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3474. doi:
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      Karin Kobuch, Raphael Neuhann, Kerstin Wand, Johannes Junger, Michael Baumann, Roland Ritter, Mohammad Islam, May Griffith, Chris Lohmann, ; Implantation of Biosynthetic Collagen III Corneal Implants in vivo in Rabbit Eyes: Surgical Technique and Clinical Performance. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3474.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To assess laser assisted implantation , sutureless fixation by UV crosslinking and clinical performance of biosynthetic collagen III implants in vivo in rabbit eyes after deep anterior lamellar keratoplasty (DALK).

Methods: Corneal implants from recombinant human collagen III (RHC III or RHC/MPC, 300µm thickness, diameter 6mm) were placed on the anterior cornea of rabbit eyes (n=12) after performing DALK with either femtosecond (Victus, Technolas PV Munich, Germany) or excimer laser (MLase Germering, Germany). Implants were prepared in a corresponding design. After application of Riboflavin 0.1% for 5 minutes UV-crosslinking was performed according to a rapid procedure (18mW/cm2 for 5 minutes). Thereafter a soft bandage contact lens was placed and a tarsoraphy was performed. Postoperatively the rabbits were observed over two or six weeks by OCT and slitlamp biomicroscopy. Finally the eyes were examined histologically (HE-stained/ picrosirius stained sections, electronmicroscopy).

Results: Femtosecond laser assisted surgery enabled a 3D cut design for fixation of the implant. Both laser cuts showed excellent surface properties within the corneal bed and implant. Certain types of implants showed minor shrinkage after crosslinking, resulting in peripheral missmatch and reduced adhesion. Good corneal adhesion and fixation of the implant could be achieved in areas, where implant and corneal bed were in close contact intraoperatively and after crosslinking, demonstrated by OCT and histology. Loss of implant during follow up occured in 4 cases due to intra- and postoperative complications (laser n=2, opening of tarsoraphy n=2). Corneal neovascularisation was observed around the implant in 3 cases, but never within the implant. Histology showed good integration of the implant, reepithelisation and repopularisation with keratocytes.

Conclusions: Laser assisted surgery and sutureless fixation by UV crosslinking show an excellent potential to optimize the surgical procedure and minimize complications for implantation of collagen III biosynthetic corneal implants. The procedure may be more complicated in rabbit eyes due to anatomical differences like reduced corneal thickness and different corneal curvature. The parameters for laser application will have to be further adapted to guarantee exact fitting and contact of implant and recipient cornea.

Keywords: 479 cornea: clinical science • 575 keratoprostheses  
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