Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.
Institute of Physics, University of São Paulo, São Carlos, Brazil.
Transl Vis Sci Technol. 2022 Aug 1;11(8):14. doi: 10.1167/tvst.11.8.14.
To evaluate the surgical technique, clinical performance, and biocompatibility of a novel keratoprosthesis (KPro) named KPro of Brazil (KoBra) in an alkali-burned rabbit model.
Two-piece three-dimensional-printed titanium powder and polymethyl methacrylate KPros were implanted into 14 alkali-burned corneas of 14 rabbits using an autologous full-thickness corneal graft as the KPro carrier. Rabbits were examined weekly for 12 months to evaluate retention and postoperative complications. Anterior segment optical coherence tomography (AS-OCT) and scanning electron microscopy (SEM) were performed at the end of the experiment to evaluate the relationship between the KoBra and the carrier graft.
All surgeries were performed without intraoperative complications, and the immediate postoperative period was uneventful. In 12 eyes (85.7%), the implanted KPros integrated into the operated eyes and maintained clear optics without extrusion or further complications over 12 months. Two eyes presented late postoperative complications that progressed to KPro extrusion: one had a presumed infectious keratitis, and the other had sterile stromal necrosis. AS-OCT demonstrated the correct relationship of the device and carrier graft in all remaining animals at the final follow-up. SEM findings indicate the integration of the porous structure of the back plate into the surrounding tissue.
Clinical evaluations, AS-OCT, and SEM findings indicate good biointegr-ation of the implanted device into the corneal carrier graft. KoBra has the advantage of using recipients' own corneas as the prosthesis supporter, and its surgical procedure is relatively simple and safe.
Titanium three-dimensional-printed technology used in an animal limbal stem-cell deficiency model holds great promise for the treatment of corneal blindness in humans.
评估一种名为巴西角膜（KoBra）的新型角膜假体（KPro）在碱性烧伤兔模型中的手术技术、临床效果和生物相容性。
使用自体全厚角膜移植物作为 KPro 载体，将两部分三维打印钛粉和聚甲基丙烯酸甲酯 KPro 植入 14 只碱性烧伤兔的 14 只角膜中。术后 12 个月内每周对兔子进行检查，以评估保留和术后并发症。实验结束时进行眼前节光学相干断层扫描（AS-OCT）和扫描电子显微镜（SEM）检查，以评估 KoBra 与载体移植物之间的关系。
所有手术均无术中并发症，术后即刻情况良好。在 12 只眼（85.7%）中，植入的 KPro 与手术眼融合，并在 12 个月内保持清晰的光学效果，无挤出或进一步并发症。2 只眼出现晚期术后并发症，导致 KPro 挤出：1 只眼疑似感染性角膜炎，另 1 只眼无菌性基质坏死。在最后一次随访时，所有其余动物的 AS-OCT 均显示出正确的设备和载体移植物关系。SEM 结果表明，后板的多孔结构与周围组织整合良好。
临床评估、AS-OCT 和 SEM 结果表明，植入的设备与角膜载体移植物之间有良好的生物整合。KoBra 的优点是使用受者自身的角膜作为假体支撑，其手术过程相对简单安全。
胡俊
