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Karin A. Kobuch, Katharina Plank, Christoph Winkler von Mohrenfels, Verena Engelmann, Sarah Pfrommer, Michael Baumann, Johannes Junger, Kimberley Merrett, May Griffith, Chris P. Lohmann; UV-Crosslinking for Sutureless Fixation of Biosynthetic Corneal Implants after Lamellar Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2011;52(14):349.
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To develop and investigate a surgical technique for sutureless fixation of new biosynthetic corneal implants by UV-collagen crosslinking ex vivo in porcine eyes.
Biosynthetic implants, 350µm thick, were fabricated from recombinant human collagen type III for replacement of the anterior cornea after lamellar keratoplasty. Surgery was performed on enucleated porcine eyes either with a 6 mm trephine, or femtolaser-assisted (Wave Light GmbH Erlangen, Germany). After application of riboflavin 0.1% on the corneal bed and the implant, crosslinking was performed by UV radiation (365nm, 3mW/cm², 30min; MLase AG, Germering Germany). Thereafter the corneae within a thin sclera ring were excised and prepared for histological examination (fixation in PFA4%, Paraffin-embedding). Morphological evaluation of crosslinking effects was performed on HE-stained and picrosirius-stained sections and by scanning electron microscopy of the implant / corneal interface. Specimens without UV radiation and with allografts were used as controls.
The optical and mechanical properties of the implants were ideal for the surgical techniques we used. After Riboflavin/UV-crosslinking the implants remained permanently adhesive within the corneal bed during all further procedures. In contrast, implants detached completely in controls without UV radiation. An intensive contact at the implant/cornea interface with connecting collagen structures could be demonstrated in histological sections by HE-staining, special staining for collagen (picrosirius) and by scanning electron microscopy.
These first morphological results show that Riboflavin /UV collagen crosslinking may provide excellent support for atraumatic, sutureless fixation of free corneal implants and thus reduce irritations and complications which can be caused by sutures.
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