PT  - JOURNAL ARTICLE
AU  - Shimmura, S
AU  - Miyashita, H
AU  - Uchino, Y
AU  - Taguchi, T
AU  - Kobayashi, H
AU  - Shimazaki, J
AU  - Tanaka, J
AU  - Tsubota, K
TI  - Microkeratome assisted deep lamellar keratoprosthesis
AID  - 10.1136/bjo.2006.090324
DP  - 2006 Jul 01
TA  - British Journal of Ophthalmology
PG  - 826--829
VI  - 90
IP  - 7
4099  - http://bjo.bmj.com/content/90/7/826.short
4100  - http://bjo.bmj.com/content/90/7/826.full
SO  - Br J Ophthalmol2006 Jul 01; 90
AB  - 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 clear 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.