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Proceedings Paper

Synthetic cornea: biocompatibility and optics
Author(s): Jean-Marie A. Parel; Stefan Kaminski; Viviana Fernandez; E. Alfonso; Peggy Lamar; Emmanuel Lacombe M.D.; Bernard Duchesne M.D.; Sander Dubovy; Fabrice Manns; Pascal O. Rol
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Paper Abstract

Purpose. Experimentally find a method to provide a safe surgical technique and an inexpensive and long lasting mesoplant for the restoration of vision in patients with bilateral corneal blindness due to ocular surface and stromal diseases. Methods. Identify the least invasive and the safest surgical technique for synthetic cornea implantation. Identify the most compatible biomaterials and the optimal shape a synthetic cornea must have to last a long time when implanted in vivo. Results. Penetrating procedures were deemed too invasive, time consuming, difficult and prone to long term complications. Therefore a non-penetrating delamination technique with central trephination was developed to preserve the integrity of Descemet's membrane and the anterior segment. Even though this approach limits the number of indications, it is acceptable since the majority of patients only have opacities in the stroma. The prosthesis was designed to fit in the removed tissue plane with its skirt fitted under the delaminated stroma. To improve retention, the trephination wall was made conical with the smallest opening on the anterior surface and a hat-shaped mesoplant was made to fit. The skirt was perforated in its perimeter to allow passage of nutrients and tissues ingrowths. To simplify the fabrication procedure, the haptic and optic were made of the same polymer. The intrastromal biocompatibility of several hydrogels was found superior to current clinically used PMMA and PTFE materials. Monobloc mesoplants made of 4 different materials were implanted in rabbits and followed weekly until extrusion occurred. Some remained optically clear allowing for fundus photography. Conclusions. Hydrogel synthetic corneas can be made to survive for periods longer than 1 year. ArF excimer laser photoablation studies are needed to determine the refractive correction potential of these mesoplants. A pilot FDA clinical trial is needed to assess the mesoplant efficacy and very long-term stability.

Paper Details

Date Published: 13 June 2002
PDF: 6 pages
Proc. SPIE 4611, Ophthalmic Technologies XII, (13 June 2002); doi: 10.1117/12.470584
Show Author Affiliations
Jean-Marie A. Parel, Univ. of Miami School of Medicine and Univ. de Liege (United States)
Stefan Kaminski, Univ. of Miami School of Medicine and Univ. of Vienna (Austria)
Viviana Fernandez, Univ. of Miami School of Medicine (United States)
E. Alfonso, Univ. of Miami School of Medicine (United States)
Peggy Lamar, Univ. of Miami School of Medicine (United States)
Emmanuel Lacombe M.D., Univ of Miami School of Medicine and Rothschild Hospital (France)
Bernard Duchesne M.D., Univ. of Miami School of Medicine and Univ. de Liege (Belgium)
Sander Dubovy, Univ. of Miami School of Medicine (United States)
Fabrice Manns, Univ. of Miami (United States)
Pascal O. Rol, Univ. of Miami (Switzerland)

Published in SPIE Proceedings Vol. 4611:
Ophthalmic Technologies XII
Fabrice Manns; Per G. Soederberg; Arthur Ho, Editor(s)

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