Ma Jinlei, Wu Fangyuan, Liu Zhiyong, Fang Yijiong, Chu Xu, Zheng Linyan, Xue Anquan, Nan Kaihui, Qu Jia, Cheng Lingyun
School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Front Med (Lausanne). 2022 May 16;9:888542. doi: 10.3389/fmed.2022.888542. eCollection 2022.
To characterize biomechanical properties of genipin-crosslinked human dura mater as reinforcing material for posterior scleral reinforcement (PSR) and to compare it with crosslinked human sclera.
Donor dura mater and sclera were crosslinked in the same optimized genipin solution. Resistance to enzyme degradation for both materials were investigated by exposing the materials to accelerated enzyme degrading. Elastic modulus and tensile strength were measured by biomechanics testing equipment. Crosslinked human dura mater was used as reinforcing patch in PSR on 57 adult pathologic myopic eyes. The patients were followed up for an average 3 years. The main outcome was eye globe axial length change and safety profile of the reinforcing material.
Crosslinked dura mater demonstrated similar percentage weight loss to crosslinked sclera when exposed to enzymatic solution. Dura mater has higher density than sclera. The retaining elastic modulus after enzyme exposure was 72.02 MPa for crosslinked dura mater while 53.88 MPa for crosslinked sclera, 34% greater for crosslinked dura mater, = 0.0186). At the end of 3 years follow-up, the mean globe axis of the surgery eyes was reduced by 1.29 mm (from 30.81 to 29.51 mm, < 0.0001, paired -test). Visual acuity (BCVA logMar) improved by 0.10 logMar unit which is an improvement of five letters ( = 0.0184, paired -test). No material specific complication was noted.
Crosslinked human dura mater may be superior to crosslinked human sclera as reinforcing material for PSR to manage progression of high myopia. This material was well tolerated on human eye.
表征京尼平交联的人硬脑膜作为后巩膜加固术（PSR）增强材料的生物力学特性，并将其与交联的人巩膜进行比较。
供体硬脑膜和巩膜在相同的优化京尼平溶液中交联。通过将材料暴露于加速酶降解来研究两种材料的抗酶降解性。用生物力学测试设备测量弹性模量和拉伸强度。将交联的人硬脑膜用作57只成人病理性近视眼睛PSR的增强补片。对患者进行平均3年的随访。主要结果是眼球轴长变化和增强材料的安全性。
暴露于酶溶液时，交联硬脑膜的重量损失百分比与交联巩膜相似。硬脑膜的密度高于巩膜。酶暴露后交联硬脑膜的保留弹性模量为72.02MPa，交联巩膜为53.88MPa，交联硬脑膜高34%（P = 0.0186）。在3年随访结束时，手术眼的平均眼轴缩短了1.29mm（从30.81mm降至29.51mm，P < 0.0001，配对t检验）。视力（BCVA logMar）提高了0.10 logMar单位，相当于提高了五行（P = 0.0184，配对t检验）。未观察到材料特异性并发症。
作为PSR治疗高度近视进展的增强材料，交联的人硬脑膜可能优于交联的人巩膜。这种材料在人眼中耐受性良好。
