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Abstract
This study compared the effects of implanting two interpenetrating polymer networks (IPNs) into rabbit corneas. The first (Implant 1) was based on PEG-diacrylate, the second (Implant 2) was based on PEG-diacrylamide. There were inserted into deep stromal pockets created using a manual surgical technique for either 3 or 6 months. The implanted corneas were compared with normal and sham-operated corneas through slit lamp observation, anterior segment optical coherence tomography, in vivo confocal scanning and histological examination. Corneas with Implant 1 (based on PEG-diacrylate) developed diffuse haze, ulcers and opacities within 3 months, while corneas with Implant 2 (based on PEG-diacrylamide) remained clear at 6 months. They also exhibited normal numbers of epithelial cell layers, without any immune cell infiltration, inflammation, oedema or neovascularisation at post-operative 6 month. Morphological studies showed transient epithelial layer thinning over the hydrogel inserted area and elevated keratocyte activity at 3 months; however, the epithelium thickness and keratocyte morphology were improved at 6 months. Implant 2 exhibited superior in vivo biocompatibility and higher optical clarity than Implant 1. PEG-diacrylamide-based IPN hydrogel is therefore a potential candidate for corneal inlays to correct refractive error.
Highlights
According to a recent review, 95.4 % patients worldwide undergoing LASIK were satisfied with their outcomes [1], making LASIK one of the most successful elective procedures performed
Causes of dissatisfaction were associated with corneal haze, diffuse lamellar keratitis, flaprelated problems, epithelial ingrowth, corneal ectasia and dry eye
The interpenetrating polymer networks (IPNs) was washed in phosphate buffer saline (PBS) until the pH and salt concentrations were equilibrated
Summary
According to a recent review, 95.4 % patients worldwide undergoing LASIK were satisfied with their outcomes [1], making LASIK one of the most successful elective procedures performed. The remaining 4.6 % of these patients (approximately 750,000 people) were dissatisfied with the procedure. Causes of dissatisfaction were associated with corneal haze, diffuse lamellar keratitis, flaprelated problems, epithelial ingrowth, corneal ectasia and dry eye. While improvements in laser technologies that include the use of eye trackers, smoother corneal ablations and customised ablation profiles may reduce some of these problems, all laser-based procedures run the inherent intrinsic risk of causing irreversible ablation to the cornea. One of the most serious complications of laser-based procedures is LASIK-induced ectasia [2]. The identification of patients at risk of ectasia is a major difficulty for refractive surgeons. Many risk factors for post-surgical ectasia have been identified, they do not indicate causation,
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