State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 510060, PR China.
PCFM Lab, GD HPPC Lab, School of Chemistry, and Guangdong Functional Biomaterials Engineering Technology Research Center, School of Materials Science and Engineering, Sun Yat-Sen University, 510275, PR China.
Acta Biomater. 2022 Sep 15;150:154-167. doi: 10.1016/j.actbio.2022.07.035. Epub 2022 Jul 25.
Substantial evidence has demonstrated the application of fresh and decellularized human corneal lenticules from increasing myopic surgeries. Further preservation of decellularized corneal lenticules would extend its clinical application. However, whether fresh and preserved decellularized lenticules have the same effects in vivo, including refractive correction, remains unclear. Here, we made comprehensive comparisons between fresh human lenticules (FHLs) and preserved decellularized human lenticules (DHLs). Another group of decellularized lenticules was combined with crosslinking for potential keratoconus therapy. Optical transparency, biomechanical properties, and fibrillar ultrastructure were analyzed to evaluate the DHLs and crosslinked DHLs (cDHLs) in vitro. The DHLs retained high transparency and regular ultrastructure, with genetic materials mostly being eliminated. The strength of lenticules in the cDHL group was markedly increased by crosslinking. Moreover, after storage in glycerol for 3 months, the lenticules were reimplanted into rabbit corneal lamellar pockets assisted by a femtosecond laser. The rabbits were followed for another 3 months. There were no obvious rejective complications in any of the three groups. From 1 week to 3 months postoperatively, the host corneas of the FHL group remained highly transparent, while slight hazes were observed in the DHL group. However, the corneas of the cDHL group displayed opacity throughout the 3-month postoperative period. Furthermore, all the lenticules could effectively induce corneal steepening and refractive changes. Taken together, our data indicated that FHLs are ideal inlay products, whereas preserved DHLs could be an alternative for intrastromal lamellar keratoplasty. Our study provides new insights into the clinical application of human lenticule recycling. STATEMENT OF SIGNIFICANCE: Currently, substantial evidence has demonstrated the application of fresh and decellularized human corneal lenticules from increasing myopic surgeries. Further preservation of decellularized lenticules would extend its clinical application. However, whether fresh and preserved decellularized lenticules have the same effects in vivo, including refractive correction, remains unclear. Herein, we decellularized human lenticules with or without mechanically strengthened crosslinking. After storage in glycerol for 3 months, the lenticules were reimplanted into rabbit corneas. Comprehensive comparisons were performed among fresh human lenticules (FHLs), decellularized human lenticules (DHLs) and crosslinked DHLs. Our study indicated that FHLs are ideal inlay products, whereas preserved DHLs could be an alternative for intrastromal lamellar keratoplasty. Our study provides new insights into the clinical application of human lenticule recycling.
大量证据表明，应用新鲜和去细胞人眼角膜晶状体可增加近视手术。进一步保存去细胞的角膜晶状体将扩展其临床应用。然而，新鲜和保存的去细胞晶状体在体内是否具有相同的效果，包括屈光矫正，尚不清楚。在这里，我们对新鲜人晶状体（FHLs）和保存的去细胞人晶状体（DHLs）进行了全面比较。另一组去细胞晶状体与交联结合，用于潜在的圆锥角膜治疗。为了评估 DHLs 和交联 DHLs（cDHLs），我们在体外分析了光学透明度、生物力学性能和纤维状超微结构。DHLs 保留了高透明度和规则的超微结构，大部分遗传物质被消除。交联使晶状体组的晶状体强度明显增加。此外，在甘油中储存 3 个月后，通过飞秒激光辅助将晶状体重新植入兔角膜板层袋中。再观察 3 个月。三组均无明显排斥性并发症。从术后 1 周到 3 个月，FHL 组的宿主角膜保持高度透明，而 DHL 组观察到轻微的混浊。然而，cDHL 组的角膜在术后 3 个月内一直混浊。此外，所有晶状体都能有效地诱导角膜变陡和屈光变化。综上所述，我们的数据表明，FHLs 是理想的嵌体产品，而保存的 DHLs 可作为基质层间角膜移植的替代物。我们的研究为人类晶状体再循环的临床应用提供了新的见解。
