Chaum Edward
Department of Ophthalmology, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN.
Cornea. 2021 Jan;40(1):48-53. doi: 10.1097/ICO.0000000000002444.
Anterior stromal puncture is an inexpensive technique for treating recurrent corneal erosions but is often ineffective and cannot be used in the optical axis because of scarring. These studies tested a novel microfabricated imprinting instrument to assess its potential efficacy for the treatment of corneal epithelial disease in the optical axis.
The device is made using glass rods, bundled and drawn through multiple iterative cycles, and then fused under high heat to generate a solid rod comprised of many parallel, aligned, cladded fibers. The rods are sliced into discs and then etched to yield designable spikes based on the borosilicate composition of the glass.
Imprinting the cornea yields a regular pattern of imprints. Histologic studies showed both nonpenetrating stable deformations of Bowman layer, with formation of stable epithelial attachments, and full thickness penetration, with superficial ingrowth of the basal epithelium.
Microimprinted corneal tissue shows focal subepithelial scarring without evidence of optically evident anterior stromal scarring, and may be an effective way of treating recurrent corneal erosions in the optical axis, which is not currently possible using standard anterior stromal puncture methods.
前基质穿刺是一种治疗复发性角膜糜烂的低成本技术，但通常效果不佳，且由于瘢痕形成不能用于视轴。这些研究测试了一种新型的微制造压印器械，以评估其治疗视轴角膜上皮疾病的潜在疗效。
该装置由玻璃棒制成，经过多次迭代循环进行捆扎和拉伸，然后在高温下熔合，生成由许多平行、排列、包层纤维组成的实心棒。将棒切成圆盘，然后根据玻璃的硼硅酸盐成分进行蚀刻，以产生可设计的尖刺。
对角膜进行压印可产生规则的压印图案。组织学研究显示，Bowman层有非穿透性稳定变形，形成稳定的上皮附着，以及全层穿透，基底上皮浅层向内生长。
微压印角膜组织显示局灶性上皮下瘢痕形成，无明显的前基质瘢痕形成证据，可能是治疗视轴复发性角膜糜烂的有效方法，而目前使用标准的前基质穿刺方法无法做到这一点。
