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TH Tezel, LV Del Priore, HJ Kaplan; Photomelded Bruch's Membrane Patch Grafts: A Novel Concept To Treat Bruch's Membrane Defects In Age-related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):925.
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Purpose:To determine the feasibility and optimum conditions to repair defects in the inner aspects of Bruch's membrane with photomelded Bruch's membrane patch grafts by using Rose Bengal dye in vitro. Methods:Six-millimeter explants of human peripheral inner collagenous layer were prepared from 10 aged (≷60 years-old) cadaver eyes. Exposed inner collagenous layers were coated with different concentrations of Rose Bengal (0.1-20 mM). Explants were then photomelded to each other by photoexciting Rose Bengal with a white cold light source using light intensity matched to vitrectomy endoilluminator for 3 minutes to avoid any retinal phototoxicity. Attachment strength was measured in a buoyancy chamber. Attached grafts were kept under 0.21 mN (milliNewtons) of constant tractional force for 3 days to test the stability of the melding process. Results:Three minutes of exposure to 35 mW of light at a distance of 40 millimeters resulted in photomelding of exposed human inner collagenous layers to each other at concentrations above 0.1 mM. Attachment strength increased up to 14.1 N/m2 at 1.5 and 5 mM concentrations of Rose Bengal. At higher concentrations the attachment strength decreased (5.7 N/m2 and 2.83 N/m2 at 10 and 20 mM, respectively) due to collagen denaturation. The minimum concentration of Rose Bengal dye to attain strong photomelding of human inner collagenous layer grafts to each other was 1.5 mM. Photomelded grafts remained attached during the 72 hours of observation at 37ºC despite continuous traction. Conclusion:Photomelding of Bruch's membrane patch grafts may open a new horizon in repairing the defects of aged and structurally damaged subfoveal BM. Incorporating Bruch's membrane patch grafts with RPE and/or stem cells may restore the RPE beneath the fovea and recover central vision in age-related macular degeneration.
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