Microkeratome assisted deep lamellar keratoprosthesis

Shigeto Shimmura, H. Miyashita, Yuichi Uchino, T. Taguchi, H. Kobayashi, J. Shimazaki, J. Tanaka, Kazuo Tsubota

Research output: Contribution to journalArticle

Abstract

Aims: To establish a keratoprosthesis (Kpro) surgical technique that maintains an intact superficial corneal layer. Methods: A manual microkeratome (Moria LSK-1) was used to create a 130 μm flap of approximately 10 mm diameter in the right eye of Japanese white rabbits. The stoma beneath the flap area was dissected before the removal of a 5.0 mm stromal disc. A 5.0 mm collagen I immobilised poly(vinyl alcohol) (COL-PVA) disc was placed on the exposed posterior stroma close to Descemet's membrane. The flap was repositioned and fixed using 10-0 nylon sutures, which were removed 2 days following surgery. The corneas were followed clinically by slit lamp microscopy and photographs. Rabbits were sacrificed after 6 months, and the transplanted corneas were examined histologically by haematoxylin and eosin staining and immunohistochemistry against vimentin and α-smooth muscle actin (α-SMA). Results: The transplanted COL-PVA discs remained transparent throughout the study, with no complications related to the flap or overlying epithelium. The interface between COL-PVA and Descemet's membrane remained dear without signs of opacification caused by scarring or cellular deposition. Pathology revealed the intact COL-PVA polymer in the posterior stroma, with minimal cellular infiltration along the anterior and posterior interfaces. Immunohistology shows vimentin and α-SMA staining at levels comparable to lamellar keratoplasty control. Conclusions: Microkeratome assisted deep lamellar keratoprosthesis may be a safe technique for the transplantation of artificial hydrogels for therapeutic purposes.

Original languageEnglish
Pages (from-to)826-829
Number of pages4
JournalBritish Journal of Ophthalmology
Volume90
Issue number7
DOIs
Publication statusPublished - 2006 Jul

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Descemet Membrane
Vimentin
Cornea
Poly I
Staining and Labeling
Rabbits
Hydrogels
Corneal Transplantation
Nylons
Hematoxylin
Eosine Yellowish-(YS)
Ambulatory Surgical Procedures
Sutures
Cicatrix
Smooth Muscle
Actins
Polymers
Collagen
Epithelium
Transplantation

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Microkeratome assisted deep lamellar keratoprosthesis. / Shimmura, Shigeto; Miyashita, H.; Uchino, Yuichi; Taguchi, T.; Kobayashi, H.; Shimazaki, J.; Tanaka, J.; Tsubota, Kazuo.

In: British Journal of Ophthalmology, Vol. 90, No. 7, 07.2006, p. 826-829.

Research output: Contribution to journalArticle

Shimmura, S, Miyashita, H, Uchino, Y, Taguchi, T, Kobayashi, H, Shimazaki, J, Tanaka, J & Tsubota, K 2006, 'Microkeratome assisted deep lamellar keratoprosthesis', British Journal of Ophthalmology, vol. 90, no. 7, pp. 826-829. https://doi.org/10.1136/bjo.2006.090324
Shimmura, Shigeto ; Miyashita, H. ; Uchino, Yuichi ; Taguchi, T. ; Kobayashi, H. ; Shimazaki, J. ; Tanaka, J. ; Tsubota, Kazuo. / Microkeratome assisted deep lamellar keratoprosthesis. In: British Journal of Ophthalmology. 2006 ; Vol. 90, No. 7. pp. 826-829.
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