<strong>ARVO</strong> 2013 Annual Meeting Abstracts by Scientific Section/Group - <strong>Cornea</strong>postoperatively.Methods: Retrospective chart review. Preoperative, intraoperative,and postoperative data were collected from a total of 17 eyes from 16patients who received a Boston keratoprosthesis and had previoussilicone oil, absence of prior corneal surgery, or postoperative sclerallens use.Results: 17 eyes from 16 patients were included in the study. Foureyes (24%) had silicone oil prior to keratoprosthesis placement, teneyes (59%) had no prior history of corneal surgery, and four eyes(24%) received a Jupiter scleral contact lens following the operation.In the four eyes that had silicone oil prior to keratoprosthesisplacement, preoperative visual acuity ranged from light perception tohand motion. All four eyes (100%) developed retroprosthesismembranes postoperatively, three of which (75%) required surgicalexcision. Only one eye (25%) attained visual acuity ≥20/200 at afollow-up of 29 months. In the ten eyes with no prior history ofcorneal surgery, preoperative visual acuity ranged from lightperception to 20/400. Postoperatively, eight eyes (80%) attainedvisual acuity ≥20/200 at an average follow-up of 22.8 months. In thefour eyes that received a scleral contact lens (SCL) following theoperation, preoperative visual acuity ranged from hand motion to20/400. Postoperatively, all four eyes (100%) attained visual acuity≥20/200 at an average follow-up of 11.7 months.Conclusions: Implantation of a Boston keratoprosthesis in eyes thatpreviously had silicone oil should be considered with caution as theseeyes may have poor postoperative visual acuity and may developdense retroprosthesis membranes. The Boston keratoprosthesis hasfavorable visual acuity outcomes in eyes without a prior history ofcorneal surgery. Postoperative use of scleral contact lenses in patientswith keratoprosthesis is well-tolerated.Commercial Relationships: Kareem Moussa, None; JohnPetrowski, None; Natalie A. Afshari, NoneProgram Number: 3476 Poster Board Number: D0103Presentation Time: 11:00 AM - 12:45 PMEvaluation Of The Interface Between Keratoprosthesis andDonor <strong>Cornea</strong> By Anterior Segment OCTRiccardo Scotto, Marina Papadia, Alessandro Bagnis, Carlo EnricoTraverso. Ophthalmology, DiNOGMI, University of Genoa, Genova,Italy.Purpose: The synthetic Keratoprosthesis can restore visual functionin patients affected by corneal blindness that are poor candidates forkeratoplasty. Advances in medical treatment have resulted in amarked improvement in retention rates and visual outcomes. AnteriorSegment (AS) OCT imaging provides additional information aboutthe status of the prosthesis and the donor graft cornea.Methods: AS-OCT imaging was performed at every follow-up visitto analyze prosthesis structure, iris position and interface betweendevice and donor cornea.Results: Five eyes of 5 patients implanted with the Boston type Ikeratoprosthesis, between 2008 and 2011, were included in thisretrospective analysis. Mean corneal thickness near the prosthesiswas 626 ±34 μm (range 549-694 μm) in the nasal sector, and 643 ±59μm in the temporal sector (range 571-657 μm).Conclusions: Spectral-domain AS-OCT allows high resolutionimaging of the keratoprosthesis device-donor cornea interface,precise visualization of the iris profile and quantification of the iridocornealangle. This imaging technique, able to provide highresolutionimages of the anterior segment, can help identify the riskfor keratoprosthesis-related complications, such as corneal meltingand angle closure glaucoma.Commercial Relationships: Riccardo Scotto, None; MarinaPapadia, None; Alessandro Bagnis, None; Carlo Enrico Traverso,MSD (F), Alcon (F), Santen (F), Thea (F), Allergan (F)Program Number: 3477 Poster Board Number: D0104Presentation Time: 11:00 AM - 12:45 PMChondro-ocular graft transfer:: An alternative to allografttransplantation?David Myung 1 , Christopher N. Ta 1 , Edward Yung 2 , Curtis W. Frank 3 .1 Ophthalmology, Stanford University School of Medicine, Byers EyeInstitute, Palo Alto, CA; 2 Santa Clara Valley Medical Center, SantaClara, CA; 3 Chemical Engineering, Stanford University, Stanford,CA.Purpose: To evaluate the use of cartilage as a potential corneal andscleral graft material in order to possibly increase donor tissueavailability worldwide, as well as to explore a new avenue towardcorneal tissue replacement in cases of repeat allograft rejectionthrough chondro-kerato autograft transfer.Methods: Cartilage specimens were harvested from animals fromvarious anatomic locations, and cut into circular discs. Glycerol wasused to dehydrate the samples to varying water content levels. Allspecimens were weighed and measured before and after dehydration.Specimens were then crosslinked at various levels of hydration usingriboflavin-5-phosphate at UV light. The dimensional stability andwater content of the crosslinked samples were then measured. Bothcrosslinked and uncrosslinked, and hydrated and dehydratedspecimens were then processed for histological evaluation andcompared to corneal tissue.Results: Dehydration of cartilage using glycerol renders it lessopaque and more transparent. The effect of crosslinking on thedimensional stability of cartilage tissue were analyzed both in termsof water content changes, transparency, and histological morphology.Conclusions: Much of the developing world lacks access to donorcorneal and scleral tissue. Chondral allografts or xenografts to replacethese tissues could be aninexpensive solution to meet this worldwide clinical need. Inaddition, chondro-kerato autograft transfer may provide a way todeliver viable corneal replacement tissue to the eyes of patients whohave suffered from repeat allograft failures.Commercial Relationships: David Myung, None; Christopher N.Ta, Stanford University (P); Edward Yung, None; Curtis W.Frank, NoneProgram Number: 3478 Poster Board Number: D0105Presentation Time: 11:00 AM - 12:45 PMPolydopamine-coated and polyethylene glycol-impregnatedcorneas as tissue carriers for the Boston KeratoprosthesisSara Bozorg 1 , Kyung Jae Jeong 2 , Samer N. Arafat 1 , Daniel S.Kohane 2 , Claes H. Dohlman 1 . 1 Department of Ophthalmology,Massachusetts Eye and Ear Infirmary, Boston, MA; 2 Department ofAnesthesiology, Division of Critical Care Medicine, Children'sHospital Boston, Harvard Medical School, Boston, MA.Purpose: To assess the integration and resistance to enzymaticdegradation of porcine corneas impregnated with polyethylene glycol(PEG) or coated with polydopamine (PDA). The aim is to be able touse each modified tissue as a carrier for the Boston Keratoprosthesis.Methods: Porcine corneas were lyophilized then rehydrated in eitherA) phosphate buffer saline (PBS), B) PEG solution (10% w/v) forone day then cross-linked with ultraviolet light, C) dopamine solution(2mg/mL in Tris buffer, pH 8.7) for one day, which polymerized(polydopamine, PDA) and coated the corneas. (n = 15 trephinedbuttons in each group). Integration of PEG hydrogel with cornea wasevaluated by scanning electrom microscopy (SEM) as well as by©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the <strong>ARVO</strong> Office at arvo@arvo.org.
<strong>ARVO</strong> 2013 Annual Meeting Abstracts by Scientific Section/Group - <strong>Cornea</strong>measuring the compressive moduli. Resistance of the corneas toenzymatic degradation was evaluated by exposure to clostridiumcollagenase solution.Results: Porcine corneas coated with PDA (Group C) showedsignificantly longer degradation time (>91h) than both control(5.0±0.7 h) and PEG treated groups (26±2.7 h). Mechanical strengthtesting revealed a difference between both PEG and PDA treatedgroups compared to the control group.Conclusions: PEG- and PDA-modified corneas showed a markedlyincreased resistance to enzymatic degradation. The creation of amussel inspired PDA coating on corneas may increase the strengthand effectiveness of keratoprosthesis carrier tissue. In addition, PDAmodifiedcorneas turn black which would reduce glare - a majorproblem in many keratoprosthesis cases (aniridia, etc.). Further invivo studies are needed to assess the viability and safety of thesemodified corneas.PMMA structures. Image projections created via confocalmicroscopy show that the depth of cell growth in Gas FoamedPHEMA-PMMA was greater than that observed on Salt PHEMA-PMMA. Day 7 image projections of Gas Foamed PHEMA-PMMAshow viable cells at depths of approximately 100 µm below thesurface on which cells were seeded. For Salt PHEMA-PMMA, thedepth of cell growth is less pronounced at day 7; however, cellproliferation data confirms that Salt PHEMA-PMMA structures arecytocompatible. SEM and μCT data indicate that both structures havea high density of pores. Among the two structures, Gas FoamedPHEMA-PMMA appeared to have the higher pore interconnectivity.For Gas Foamed PHEMA-PMMA, elastic modulus (E) and ultimatetensile strength (UTS) are 4081 ± 808 kPa and 263 ± 66 kPa,respectively. For Salt PHEMA-PMMA, E and UTS are 678 ± 72 kPaand 125 ± 25 kPa, respectively.Conclusions: Pore architecture, mechanical stability, andcytocompatibility are vital design parameters for KPros. PorousPHEMA-PMMA is cytocompatible. Increased pore interconnectivityappears to allow greater cell growth into the body of porousPHEMA-PMMA structures. The polymers appear to be strongenough to be sutured and to maintain their structures under ocularforces as host tissue integrates. KPros made with porous PHEMA-PMMA may provide additional options for patients for whom donorcorneas are inappropriate or inaccessible.Polydopamine modified cornea as carrier for the BostonKeratoprosthesis.Commercial Relationships: Sara Bozorg, None; Kyung Jae Jeong,None; Samer N. Arafat, None; Daniel S. Kohane, None; Claes H.Dohlman, NoneProgram Number: 3479 Poster Board Number: D0106Presentation Time: 11:00 AM - 12:45 PMDesigning a Novel Porous Keratoprosthesis to Promote <strong>Cornea</strong>Cell IngrowthAmelia L. Zellander 1 , Richard A. Gemeinhart 2 , Behrad Milani 3 , AliR. Djalilian 3 , Mohsen Makhsous 4 , Michael Cho 1 . 1 Bioengineering,University of Illinois at Chicago, Chicago, IL; 2 BiopharmaceuticalSciences, University of Illinois at Chicago, Chicago, IL;3 Ophthalmology and Visual Sciences, University of Illinois atChicago, Chicago, IL; 4 Physical Medicine and Human MovementSciences, Northwestern University, Chicago, IL.Purpose: Limited donor cornea supplies and cornea transplantrejection necessitate the development of safe and effectivekeratoprostheses (KPros). This study evaluates cell growth into novelporous polymers that could be used in a corneal replacement device.Methods: Porous Salt PHEMA-PMMA was composed of 10% v/vmethyl methacrylate (MMA), 45% v/v 2-hydroxyethyl methacrylate(HEMA), and 0.07 M sodium chloride. Porous Gas FoamedPHEMA-PMMA was composed of 20% v/v MMA and 40% v/vHEMA. Prior to the introduction of human corneal fibroblasts(HCFs), polymer samples were coated with collagen type I. Cellproliferation and viability were assessed using AlamarBlue and LiveDead Cell Viability assays (Invitrogen), respectively. The structuresof the porous PHEMA-PMMA samples were evaluated usingscanning electron microscopy (SEM) and micro-computedtomography (μCT). Mechanical properties were evaluated in tension.Results: A high level of cell viability was observed on PHEMA-SEM ImagesCommercial Relationships: Amelia L. Zellander, Tebios (F);Richard A. Gemeinhart, None; Behrad Milani, None; Ali R.Djalilian, None; Mohsen Makhsous, None; Michael Cho, NoneSupport: Office of Naval Research N00014-06-1-0100Program Number: 3480 Poster Board Number: D0107Presentation Time: 11:00 AM - 12:45 PMA fish scale-derived scaffold for corneal reconstructionT H. van Essen 1 , Sarah J. Sparks 2 , Lisanne van Zijl 2 , Greg Chen 3 ,Chien C. Lin 3 , Horng J. Lai 3 , Gregorius P. Luyten 1 , Abdoelwaheb ElGhalbzouri 2 , Martine J. Jager 1 . 1 Ophthalmology, Leiden UnivMedical Center, Leiden, Netherlands; 2 Dermatology, Leiden UnivMedical Center, Leiden, Netherlands; 3 Research, Aeon AstronEurope B.V., Leiden, Netherlands.Purpose: A natural occurring, easy obtainable fish scale-derivedcollagen scaffold (FSCS) has been developed for reconstructing thecornea. This FSCS could form a cheap and simple alternative tocurrent keratoprostheses. We assessed in vitro whether the FSCS canbe repopulated by epithelium and fibroblasts. In addition, weevaluated cell adhesion of the FSCS and measured its opticalproperties.Methods: The light scattering and transmission values of the FSCS, adecalcified and decellularized layered build collagen type Iextracellular matrix, were measured. In addition, human cornealepithelial cells (HCECs) and human corneal stromal cells were coculturedwith the FSCS. Dispase and laser treatments were used tooptimize entrance for stromal cells into the FSCS. The cytotoxicity ofFSCS was assessed using an MTT assay. The effect of FSCS oncellular repopulation, morphology, phenotype, and adhesion were©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the <strong>ARVO</strong> Office at arvo@arvo.org.
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