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I. Brunette, S. Proulx, T. Bensaoula, O. Nada, A. Devaux, G. Allaire, L. Germain; In vivo Transplantation of a Reconstructed Posterior Cornea in the Feline Model. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2327. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the functional outcome of corneal transplantation with bioengineered posterior corneas in the feline model.
17 healthy adult cats (mean weight 4.23 ± 0.83 kg) underwent full thickness corneal transplantation. In 11 animals, the donor cornea was reconstructed from cultured allogeneic feline corneal endothelial cells seeded on the denuded Descemet’s membrane of a decellularized human cornea. The reconstructed endothelium was further cultured for 2 weeks before transplantation. Six control animals received either an autologous (n=1), an allogeneic (n=2) or a human xenogeneic native cornea, either with (n=1) or without an endothelium (n=2). One eye per animal was randomly assigned to surgery. Animals were observed daily and euthanized on day 7. Postmortem assessment included optical coherence tomography, alizarin red staining, histology, scanning (SEM) and transmission (TEM) electron microscopy.
Surgical handling of the reconstructed donor corneas was quite similar to that of native human eye bank donors, with the exception that the reconstructed donors were entirely de-epithelialized. All 17 grafts were clear at Day 7, except 1 reconstructed graft in which the endothelium was partly detached and the 2 controls with no endothelium. In eyes receiving a reconstructed cornea, re-epithelialization was complete at Day 7 in 9 of the 11 cases, progressive graft thinning was observed in all cases (Central US pachymetry unreadable at Day 0; Day 3: 691±82 µm; Day 7: 659±117 µm; p=0.013) and IOP remained normal (Day 7: Reconstructed: 20.2±6.9 mmHg; Controls: 24.5±4.6 mmHg, p=0.12). Histology and TEM showed an endothelium of tightly-packed cells closely adherent to Descemet’s membrane. SEM confirmed that the cubical endothelial cells covered the entire graft surface.
This study provides evidence for the short term (7 days) anatomical and functional success of corneal transplantation with tissue engineered corneal endothelium. Several measures were developed to protect the reconstructed endothelium during surgery that could also be very useful in human patients.
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