Intrastromal implantation of chicken corneal grafts into the cornea of rabbits for corneal thickening: an experimental s
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ORIGINAL PAPER
Intrastromal implantation of chicken corneal grafts into the cornea of rabbits for corneal thickening: an experimental study Flavia Motta Almodin . Juliana Motta Almodin . Edna Motta Almodin Nilma Fernandes . Paulo Ferrara . Antonio Gonc¸alves
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Received: 22 April 2020 / Accepted: 17 August 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate the feasibility and effects of the intrastromal implantation of chemically modified corneal stroma obtained from chicken into the corneas of rabbits for corneal thickening. Methods Chicken corneas were cut, debrided, treated with cross-linking and implanted in an intrastromal pouch created in the cornea of 10 white New Zealand rabbits with femtosecond laser. Slit-lamp biomicroscopy and optical coherence tomography were performed immediately, 7, 30 and 90 days postoperatively. Corneas were removed at 90 days and cut in two halves. One half was sent to histological analysis for the presence of necrosis, polymorphonuclear inflammatory cells, blood vessels and fibrosis, while
F. M. Almodin (&) J. M. Almodin E. M. Almodin Provisa˜o Hospital de Olhos de Maringa´, Rua Silva Jardim, N8 359, Maringa´ 87013-010, Brazil e-mail: [email protected] F. M. Almodin A. Gonc¸alves Santa Casa de Sa˜o Paulo Medical School, Rua Dr. Cesa´rio Mota Junior, 112 - Vila Buarque, Sa˜o Paulo 01221-020, Brazil N. Fernandes State University of Maringa´, Av. Colombo, 5790 - Jd. Universita´rio, Maringa´ 87020-900, Brazil
the other half was evaluated with transmission electron microscopy to verify tissue organization and the presence of keratocytes and inflammatory cells. Corneal thicknesses were comparatively analyzed over time with Wilcoxon test (p B 0.05). Results The chicken grafts were incorporated into the cornea of all animals over time. Mean rabbit cornea thickness increased from 338 lm preoperatively to 538 lm (p \ 0.0077) at 90 days, while mean chicken graft thickness decreased from 350 to 215 lm (p \ 0.0077). No clear signs of rejection attributable to the xenograft were observed in any of the implanted eyes. However, some macroscopic and histological events were observed in some of the eyes, probably due to procedural issues during implantation. Conclusion The intrastromal implantation of chicken grafts was shown to be feasible and predictable to thicken the recipient rabbit cornea without apparent rejection. However, before being considered in humans, further meticulous clinical trials are required to establish the clinical utility, safety and efficacy of xenografts for the treatment of patients with advanced keratoconus. Keywords Keratoconus Cornea surgery Ophthalmic surgical procedures Rabbits
P. Ferrara Clı´nica de Olhos Dr. Paulo Ferrara, Av. Contorno, 4747 Bairro Serra, Belo Horizonte 30110-921, Brazil
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Int Ophthalmol
Introduction Keratoconus is a progressive cornea condition that leads to corneal protrusion, myopia and irregular astigmatism, negatively affecting visual acuity and visual quality
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