Guo Ping, Chen Jia-qi, Tan Bai-hua, Wang Zhi-chong, Liu Zu-guo, Yuan Jin, Gu Jian-jun, Huang Hai
Key Laboratory of Ophthalmology of the Ministry of Education, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Zhonghua Yan Ke Za Zhi. 2007 Jul;43(7):602-7.
To investigate the biocolonization of polyhydroxyethyl methacrylate (PHEMA) sponge with cornea tissue and evaluate the therapeutic effects of modified porous PHEMA-PMMA (polymethyl methacrylate) Keratoprostheses (KPro) on rabbit and monkey corneas.
The KPro were made using two-stage polymerization combined with mechanical cutting. The experiment was divided into two groups. In the control group (A group), ten normal rabbit eyes received lamellar implantation of PHEMA sponges. The sponges were obtained 2 weeks, 1, 2, 3 and 4 months after operation. The cell proliferation and neovascularization inside the sponges were observed using light and transmission electron microscopy (TEM) and immunohistochemistry. In the experimental group (B group), the porous PHEMA-PMMA KPros were inserted into the lamellar pockets of ten rabbit corneas and two monkey corneas (stage I operation). The healing process was investigated by slit-lamp microscopy. The anterior lamellar cornea tissues were removed 3 months after surgery, exposing the underneath transparent core (stage II operation). The operated eyes were then followed up for 3 - 6 months.
No complication was observed in A group. Under the light microscope, fibroblasts started to grow into the cornea 2 weeks after operation; lots of cells, accompanied with new blood vessels, invaded into the cornea 2 - 3 months after surgery. Invading cells of sponge, as well as keratocyte, were positive for vimentin. Under the electron microscope, the invading cells looked healthy and were surrounded by extracellular matrix and collagen. In B group, eight rabbit eyes which have received KPro implantation, anterior lamellar cornea melting happened in two eyes after the stage I operation. The remaining six corneas retained their central cores during observation after the stage II operation. Two monkey operated eyes were found no complication throughout the whole follow-up.
The PHEMA sponge can obtain a tight fusion with the host cornea. The modified PHEMA-PMMA KPros have obtained a relatively stable therapeutic results after implantation into animal corneas.
研究聚甲基丙烯酸羟乙酯（PHEMA）海绵与角膜组织的生物定植情况，并评估改良的多孔PHEMA - 聚甲基丙烯酸甲酯（PMMA）人工角膜（KPro）对兔眼和猴眼角膜的治疗效果。
采用两步聚合法结合机械切割制作KPro。实验分为两组。对照组（A组），10只正常兔眼接受PHEMA海绵板层植入。术后2周、1、2、3和4个月获取海绵。使用光学显微镜、透射电子显微镜（TEM）和免疫组织化学观察海绵内的细胞增殖和新生血管形成情况。实验组（B组），将多孔PHEMA - PMMA KPro植入10只兔眼和2只猴眼角膜的板层袋中（I期手术）。通过裂隙灯显微镜观察愈合过程。术后3个月切除前板层角膜组织，暴露下方透明核心（II期手术）。然后对手术眼进行3 - 6个月的随访。
A组未观察到并发症。光学显微镜下，术后2周成纤维细胞开始长入角膜；术后2 - 3个月大量细胞伴随新生血管侵入角膜。海绵内侵入细胞以及角膜细胞波形蛋白呈阳性。电子显微镜下，侵入细胞看起来健康，被细胞外基质和胶原包围。B组，8只接受KPro植入的兔眼中，I期手术后2只眼发生前板层角膜溶解。II期手术后观察期间，其余6只角膜保留了中央核心。2只猴手术眼在整个随访过程中未发现并发症。
PHEMA海绵可与宿主角膜紧密融合。改良的PHEMA - PMMA KPro植入动物角膜后获得了相对稳定的治疗效果。
