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F.E. Molnar, L. Lombardi, N. Berker, E. Yeh, D. Yellachich, T. Leng, R. Dalal, M.F. Marmor, H.A. Fishman, M.S. Blumenkranz; Synthetic Bruch's Membrane Substitutes: Comparisons After Subretinal Transplantation With Cultured Iris Pigment Epithelium . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4154.
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Purpose: Transplantation of retinal (RPE) or iris pigment epithelial cells (IPE) on artificial substrates could be beneficial for age related macular degeneration, since the aged Bruch's membrane may no longer be an adequate surface. We explore the use of polycarbonate (PC) and cellulose ester (CE) membranes for the implantation of cultured iris pigment epithelial cells. Methods: IPE cells were cultured on PC or CE membranes with 10 µm thickness. Autologous IPE cells were harvested by iridectomy from New Zealand red rabbits and seeded on membranes. The cultured IPE cells were analyzed by light microscopy, live/dead fluorescent staining, and immunohistochemistry. Seven membranes of each type, with confluent IPE monolayer, were implanted subretinally by raising a bleb with balanced salt solution for insertion. Eyes were removed and histological changes were analyzed at 1 and 3 months. Results: Cultures of IPE grew as monolayers on both membranes, but histochemistry showed fibrotic rather than epitheloid morphology and a loss of pigment granules. Histology of implanted membranes at both 1 and 3 months showed no inflammation, but varying degrees of fibrous proliferation above the membranes. Few IPE cells were identifiable. RPE migration was observed around the ends of the membranes. The overlying retina showed a loss of outer segments and outer nuclear layer disruption, but inner retinal layers were preserved. There was no clear difference between PC and CE, except that PC was easier to implant. Conclusions: PC and CE membranes can be implanted subretinally without rejection, although PC is easier to manipulate. IPE cultured on these substrates showed poor epithelial preservation and varying amounts of fibrous proliferation when implanted. The concept of Bruch's membrane replacement is promising, but IPE transplantation remains fraught with difficulties.
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