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X.-W. Tan, P. A. P. Perera, A. Tan, D. Tan, K. A. Khor, R. W. Beuerman, J. S. Mehta; Biocompatibility Studies of Novel Synthetic OOKP Implant Skirt Material. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1144.
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© ARVO (1962-2015); The Authors (2016-present)
Osteo-Odonto Keratoprosthesis (OOKP) is one of the most successful forms of keratoprosthesis (KPros) surgery. However, there are several limitations including a multi-step surgical procedure, high surgical complexity, advanced dental and oral maxillary surgery and the secondary resorption of OOKP lamina. The aim of this study is to establish an alternative synthetic bio-material to be used as a skirt for OOKP surgery.
Test materials were hydroxyapatite (HA), titanium oxide (TiO2), aluminum oxide (Al2O3) and yttria-stabilized zirconia (YSZ). Human corneal keratocytes were dissociated and expanded from donor cornea stroma and seeded onto the surface of biomaterials discs for further processing. Keratocytes attachment and proliferation rate at different time points (24 hours and 7 days after seeding) were assessed by cell counting and MTT assay. Morphological analysis was evaluated using immunofluorescent labelling with phalloidin F-actin, anti gelsolin, anti vinculin and anti β-integrin antibodies. Staphylococcus aureus adhesion on the substrates was evaluated with scanning electronic microscope and viable counts estimated using the spread plate method.
Cell studies indicated that TiO2 implants significantly promoted cell proliferation and cell viability compared with HA, Al2O3, and YSZ. Immunofluorescent analysis imaging analyse revealed that TiO2 surfaces were most conducive in enhancing cell spreading and cell to cell contact compared to HA and Al2O3 substrates. Bacterial adhesion on the TiO2, Al2O3, and YSZ surfaces were lower compared to that on HA substrates.
The combination of promotion of cell functions and reduction of bacterial adhesion makes TiO2 the most suitable candidate for use as skirt material to replace HA. This would in turn enhance tissue integration and reduce device failure rates during keratoprosthesis surgery.
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