In Vitro Effect of Microbial Infection on Candidate Biomaterials for Osteo-Odontoid Keratoprosthesis Skirt

Abstract

Purpose: : Artificial keratoprosthesis skirts are prone to long term corrosion and microbiological assault. The purpose of our study was to compare the inflammatory response and material dissolution properties of two candidate skirt materials, hydroxyapatite (HA) and titanium oxide (TiO2) in a simulated cornea inflammation environment.

Methods: : Lipopolysaccharide (LPS)-stimulated cytokine secretion were evaluated with human corneal fibroblasts on both HA and TiO2. Material specimens were subjected to electrochemical and long-term incubation test with artificial tear fluid of various acidities. Topography and surface roughness of material discs were analyzed by scanning electron microscopy (SEM) and atomic force microscopy (AFM).

Results: : There was less cytokines secreted from human corneal fibroblasts seeded on TiO2 substrates compared to HA. TiO2 was more resistance to the corrosion effect caused by acidic artificial tear fluid in contrast to HA. Moreover, the elemental composition of TiO2 was more stable than HA after long-term incubation with artificial tear fluid.

Conclusions: : TiO2 is a suitable material to replace HA as an OOKP skirt in terms of less inflammatory response and high corrosion resistance. This would enhance tissue integration and reduce device failure rates during keratoprosthesis surgery

Keywords: keratoprostheses • bacterial disease • inflammation