Biocompatibility and functionality of a tissue-engineered living corneal stroma transplanted in the feline eye
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Investigative ophthalmology and visual science ; vol. 55, pp. 6908-6920.Publisher(s)
Association for Research in Vision and OphthalmologyAuthor(s)
Abstract(s)
PURPOSE. Corneal tissue shortage has become a major concern worldwide, which has
motivated the search for alternative solutions to eye bank human eyes for corneal
transplantation. Minimally invasive lamellar transplantation and tissue engineering may offer
new opportunities for the rehabilitation of diseased corneas. The aim of this study was to
evaluate the biocompatibility and functionality of stromal lamellar grafts tissue-engineered
(TE) in vitro and transplanted in vivo in the cornea of a feline model.
METHODS. The corneal stromas were engineered in culture from corneal stromal cells using
the self-assembly approach, without the addition of exogenous material or scaffold. Eight
healthy animals underwent two intrastromal grafts in one eye and the contralateral eye was
used as a control. Animals were followed with slit-lamp ophthalmic examination, corneal
esthesiometry and optical coherent tomography. Confocal microscopy, immunofluorescence,
histology, and transmission electron microscopy (TEM) were performed at 4 months.
RESULTS. Four months after transplantation, the TE-stromal grafts were transparent, functional,
and well tolerated by the eye. All grafts remained avascular, with no signs of immune
rejection, despite a short course of low-dose topical steroids. Corneal sensitivity returned to
preoperative level and reinnervation of the grafts was confirmed by confocal microscopy and
immunofluorescence. Histology and TEM of the TE-grafts showed a lamellar stromal structure
with regular collagen fibril arrangement.
CONCLUSIONS. These results open the way to an entirely new therapeutic modality. Intracorneal
filling using a biocompatible, transparent, and malleable TE-stroma could be the basis for
multiple types of novel therapeutic options in corneal interventional surgery.
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