Werblin T P, Peiffer R L, Binder P S, McCarey B E, Patel A S
University of Virginia, Charlottesville.
Refract Corneal Surg. 1992 Jan-Feb;8(1):12-22.
For the past 8 years, three independent laboratories have been researching the biocompatibility and performance of Permalens intracorneal lens implants in the corneas of nonhuman primates. Both myopic and hyperopic corrections have been achieved. This article describes the evolution of the intracorneal lens design and manufacturing process.
During this time period, 63 surgeries were performed on various species of nonhuman primates. Follow-up examination extended between 30 months and 8.2 years. Objective measures of refractive performance, as well as biocompatibility were made using slit lamp, retinoscopy, autorefractor, specular microscope, etc. Additionally, histopathology was performed on many of the specimens, both acute and chronic.
Surgically successful implants were achieved in between 60% and 100% of eyes in the various series of lens implants outlined in the article. Levels of contamination in the preparation of hydrogels were felt to be responsible for many of the surgical failures. The removal of silicone and other contaminants seems to have significantly improved the biocompatibility of these materials within the cornea. The major histopathological finding was that there appeared to be some epithelial thinning over the implants, but in general excellent biocompatibility was obtained over the 8-year period outlined in this paper.
Although extensive studies of biocompatibility have been completed, the future of the performance of these materials remains to be proven in the human subject. Additionally, empirical relationships between lens implant power and refractive results will have to be determined in humans, prior to their general clinical usage.
在过去8年里,三个独立实验室一直在研究Permalens人工角膜晶状体植入物在非人灵长类动物角膜中的生物相容性和性能。已经实现了近视和远视矫正。本文描述了人工角膜晶状体设计和制造工艺的演变。
在此期间,对多种非人灵长类动物进行了63次手术。随访时间为30个月至8.2年。使用裂隙灯、检影镜、自动验光仪、角膜内皮显微镜等对屈光性能和生物相容性进行客观测量。此外,对许多急性和慢性标本进行了组织病理学检查。
在本文概述的各系列晶状体植入手术中,60%至100%的眼睛实现了手术成功植入。水凝胶制备过程中的污染水平被认为是导致许多手术失败的原因。去除硅酮和其他污染物似乎显著提高了这些材料在角膜内的生物相容性。主要的组织病理学发现是植入物上方似乎有一些上皮变薄,但总体而言,在本文所述的8年期间获得了良好的生物相容性。
尽管已经完成了广泛的生物相容性研究,但这些材料性能的未来仍有待在人体中得到证实。此外,在这些晶状体植入物广泛临床应用之前,必须在人体中确定晶状体植入物屈光度与屈光结果之间的经验关系。