Porcine Eyeballs Research Articles

Implantable Intraocular Fluorescence Sensor for Visualized Monitoring of Alzheimer's Disease

AbstractWith an increase in the older individuals, the global incidence of Alzheimer's disease (AD) is increasing. Early diagnosis of AD necessitates long‐term monitoring; however, conventional diagnostic methods such as positron emission tomography (PET) and magnetic resonance imaging (MRI) are unsuitable for frequent use because of infrastructure limitations. The eye, connected to the brain via the optic nerve, offers a potential window for monitoring neurodegenerative diseases. This study presents a novel system for continuous intraocular monitoring using a fluorescent aptamer‐conjugated intraocular lens (FAIOL). FAIOL emits fluorescent signals in the presence of beta‐secretase‐1 (BACE1), an enzyme associated with amyloid beta 1–42 production. These signals can be analyzed using mobile phone applications. In vitro, experiments demonstrates that FAIOL responded to BACE1 by detecting low concentrations of the target molecule over extended periods. Ex vivo tests using porcine eyeballs shows an increase in the fluorescence signal intensity by more than 8% within 5 h in the presence of BACE1. The integrated image analysis program reduces sensor noise and provides numerical signal values, facilitating a straightforward interpretation. FAIOL holds significant potential as an innovative platform for the early diagnosis and long‐term monitoring of AD and promises improved patient outcomes through timely intervention and ongoing surveillance.

Exploring the Feasibility of Estimating Intraocular Pressure Using Vibrational Response of the Eye: A Methodological Approach.

This study addresses the limitations of current tonometry techniques by exploring vibroacoustic properties for estimating intraocular pressure (IOP), a key diagnostic parameter for monitoring glaucoma-a significant risk factor for vision loss. Utilizing vivo porcine eyeballs, we investigated the relationship between IOP and the nonlinear vibration transfer function ratio (NVTFR). Through applying varying vibration levels and analyzing responses with transfer function analysis and univariate regression, we identified a strong negative correlation between NVTFR and IOP, evidenced by a Pearson correlation coefficient of -0.8111 and significant results from generalized linear model (GLM) regression (p-value < 0.001). These findings indicate the potential of NVTFR as a vital indicator of IOP changes. Our study highlights the feasibility of using vibroacoustic properties, specifically NVTFR, to measure IOP. While further refinement is necessary for in vivo application, this approach opens new possibilities for non-invasive and patient-friendly IOP monitoring, potentially enhancing ophthalmology diagnostic techniques and providing a foundation for future research and development in this critical area.

Development of an Ex Vivo Porcine Eye Model for Exploring the Pathogenicity of Acanthamoeba.

Acanthamoeba, a widely distributed free-living amoeba found in various environments, is an opportunistic pathogen responsible for causing Acanthamoeba keratitis, a condition that may lead to blindness. However, identifying the pathogenicity of Acanthamoeba is challenging due to its complex life cycle, ability to adapt to different environments, variable virulence factors, and intricate interactions with the host immune system. Additionally, the development of an effective model for studying Acanthamoeba pathogenicity is limited, hindering a comprehensive understanding of the mechanisms underlying its virulence and host interactions. The aim of this study was to develop an ex vivo model for Acanthamoeba infection using porcine eyeballs and to evaluate the pathogenicity of the Acanthamoeba isolates. Based on slit lamp and biopsy analysis, the developed ex vivo model is capable of successfully infecting Acanthamoeba within 3 days. Histopathological staining revealed that clinical isolates of Acanthamoeba exhibited greater corneal stroma destruction and invasion in this model than environmental isolates. Our results highlight the importance of an ex vivo porcine eye model in elucidating the pathogenesis of Acanthamoeba infection and its potential implications for understanding and managing Acanthamoeba-related ocular diseases.

Perspective use of bio-adhesive liquid crystals as ophthalmic drug delivery systems

The success of many drugs in ophthalmic treatments is hindered by their physico-chemical properties and the limited precorneal retention time. Here, lyotropic liquid crystals are proposed as a new ophthalmic drug delivery system. Acyclovir was chosen as model drug for its solubility and its controlled release from cubic phase was achieved. We demonstrated the effortless application of lamellar phase on corneal surface and its ability to convert itself in cubic phase in situ. While the complex viscosity of lamellar phase was affected by temperature (5.1 ± 1.4 kPa·s at 25 °C and 0.12 ± 0.001 Pa·s at 35 °C, respectively), the cubic phase shown no changes in viscosity values and shear thinning behaviour at both temperatures and even in presence of the drug The degradation kinetic of drug-loaded cubic phase was slightly slower than the empty formulation, recording 27.92 ± 1.43% and 33.30 ± 3.11% of weight loss after 8 h. Ex vivo studies conducted on porcine eyeballs and isolated cornea confirmed the instantaneous transition to cubic phase, its ability to resist to gravity force, and forced dripping of simulated tear fluid. Histopathological investigation showed how treated cornea did not report changes in epithelial and stroma structures. In summary, lyotropic liquid crystals could represent an advantageous ophthalmic drug delivery system.

Measuring intraocular pressure with OCT: the first approach.

The variability of corneal OCT speckle statistics is indirectly related to changes in corneal microstructure, which may be induced by intraocular pressure (IOP). A new approach is considered, which attempts to estimate IOP based on corneal speckle statistics in OCT images. An area (A) under trajectories of contrast ratio with respect to stromal depth was calculated. The proposed method was evaluated on OCT images from the ex-vivo study on porcine eyeballs and in-vivo study on human corneas. A statistically significant multivariate linear regression model was obtained from the ex-vivo study: IOP = 0.70 · A - 6.11, in which IOP was precisely controlled in the anterior chamber. The ex-vivo study showed good correlation between A and IOP (R = 0.628, at the least) whereas the in-vivo study showed poor correlation between A and clinical air-puff tonometry based estimates of IOP (R = 0.351, at the most), indicating substantial differences between the two studies. The results of the ex-vivo study show the potential for OCT speckle statistics to be utilized for measuring IOP using static corneal imaging that does not require corneal deformation. Nevertheless, further work is needed to validate this approach in living human corneas.

Refractive Outcome After Corneal Lenticule Implantation Ex Vivo Non-Human Study

Purpose To evaluate changes in corneal refractive parameters after implantation of a stromal lenticule of different thickness. We assume that the refractive outcome depends on the optical power of the used lenticule. Methods We conducted an ex-vivo non-human study on 33 normotonic porcine eyeballs divided into two groups, for 4D and 8D human lenticule implantation. Corneal stromal lenticules were obtained as a by-product from a laser procedure ReLEx SMILE. We evaluated corneal refractive parameters measured on Oculus Pentacam© device before and immediately after the intrastromal lenticule implantation. Results There was no statistically significant difference in corneal refractive parameters between the eyeball groups before lenticule implantation. In both groups, the intrastromal implantation in the depth of 300um led to a significant increase of central corneal pachymetry and corneal anterior steepening. In the 4D group the average central corneal pachymetry increased from 903 ± 124.59 to 1230 ± 148.99 (p = 0.0022) and in 8D group from 733.35 ± 69.60 to 1109 ± 161.64 (p = 0.0008). Induced changes in other studied parameters were not statistically significant, Kmax changed from 45.57 ± 2.78 to 72.07 ± 16.83 (p = 0.0094) and Km front from 40.72 ± 1.60 to 48.87 ± 5.83 (p = 0.0037) in 4D group and in the 8D group average Kmax increased from 42.22 ± 1.54 to 62.95 ± 12.67 (p = 0.0001) and K2 front 40.46 ± 1.64 to 51.51 ± 9.63 (p = 0.0037). There were no significant differences in refractive changes between the 4D and 8D groups after lenticule implantation. Conclusion Intrastromal corneal lenticule implantation induces changes in corneal refractive parameters. In both groups, the implantation induced a significant increase of an anterior corneal steepening without any significant influence on posterior corneal flattening. Corneal lenticule implantation did not lead to any significant change of corneal astigmatism. However, in order to have more precise data for future clinical applications we need to continue with the experiments and verify the results on human corneas.

Design and Experiment of an Ultrasound-Assisted Corneal Trephination System

According to the advantages of ultrasonic vibration cutting, an ultrasound-assisted corneal trepanation robotic system is developed to improve the accuracy of corneal trephination depth and corneal incision quality in corneal trephination operations. Firstly, we analyzed the reasons for the difficulty in controlling the depth of trephination in corneal transplantations from the perspective of the biomechanical properties of the cornea. Based on the advantages of ultrasonic vibration cutting, we introduced an ultrasonic-vibration-assisted cutting method for corneal trephination and analyzed the cutting mechanism. Secondly, we described the surgical demands of corneal trephination and listed the design requirements of a robotic system. Thirdly, we introduced the design details of said system, including the system's overall structure, the ultrasound-assisted end effector, the key mechanisms of the robotic system, and the human-machine interaction interface. We designed the end effector based on ultrasonic vibration cutting and its eccentric adjustment system in an innovative way. Additionally, we then presented a procedure for robot-assisted corneal trephination. Finally, we performed several cutting experiments on grapes and porcine eyeballs in vitro. The results show that, compared with manual trephine, ultrasound-assisted corneal trephination has a better operation effect on the accuracy of corneal trephination depth and corneal incision quality.

Design and Fabrication of 15-MHz Ultrasonic Transducers Based on a Textured Pb(Mg1/3Nb2/3)O3-Pb(Zr, Ti)O3 Ceramic.

Ultrasound medical imaging is an entrenched and powerful tool for medical diagnosis. Image quality in ultrasound is mainly dependent on performance of piezoelectric transducer elements, which is further related to the electromechanical performance of the constituent piezoelectric materials. With rising need for piezoelectric materials with better performance and low cost, a highly 〈001〉 textured piezo ceramic, Pb(Mg1/3Nb2/3)O3-Pb(Zr, Ti)O3, has been developed. Recently, textured ceramic materials can be produced at low cost and exhibit high piezoelectric strain constants and large electromechanical coupling coefficients. In this work, 15-MHz ultrasonic transducers with an effective aperture of 2.5 mm in diameter based on these highly 〈001〉 textured ceramics have been successfully fabricated. The fabricated transducers achieved a central frequency of 15 MHz, a fractional bandwidth of 67% (at -6 dB), a high effective electromechanical coupling coefficient [Formula: see text] of 0.55, and a low insertion loss (IL) of 21 dB. Ex vivo ultrasonic imaging of a porcine eyeball was used to assess the tomography quality of the transducer. The results show that utilized textured ceramic has a great potential in developing ultrasonic devices for biomedical imaging purposes.

Primary Culture of Porcine Retinal Pigment Epithelial Cells

The retinal pigment epithelium (RPE) is a monolayer of polarized pigmented epithelial cells, located between the choroid and neuroretina in the retina. Multiple functions, including phagocytosis, nutrient/metabolite transportation, vitamin A metabolism, etc., are conducted by the RPE on a daily basis. RPE cells are terminally differentiated epithelial cells with little or no regenerative capacity. Loss of RPE cells results in multiple eye diseases leading to visual impairment, such as age-related macular degeneration. Therefore, the establishment of an in vitro culture model of primary RPE cells, which more closely resembles the RPE in vivo than cell lines, is critical for the characteristic and mechanistic studies of RPE cells. Considering the fact that the source of human eyeballs is limited, we create a protocol to culture primary porcine RPE cells. By using this protocol, RPE cells can be easily dissociated from adult porcine eyeballs. Subsequently, these dissociated cells attach to culture dishes/inserts, proliferate to form a confluent monolayer, and quickly re-establish key features of epithelial tissue in vivo within 2 wks. By qRT-PCR, it is demonstrated that primary porcine RPE cells express multiple signature genes at comparable levels with native RPE tissue, while the expressions of most of these genes are lost/highly reduced in human RPE-like cells, ARPE-19. Moreover, the immunofluorescence staining shows the distribution of tight junction, tissue polarity, and cytoskeleton proteins, as well as the presence of RPE65, an isomerase critical for vitamin A metabolism, in cultured primary cells. Altogether, we have developed an easy-to-follow approach to culture primary porcine RPE cells with high purity and native RPE features, which could serve as a good model to understand RPE physiology, study cell toxicities, and facilitate drug screenings.

A Composite System Based upon Hydroxypropyl Cyclodextrins and Soft Hydrogel Contact Lenses for the Delivery of Therapeutic Doses of Econazole to the Cornea, In Vitro.

Fungal keratitis, a disease in which the cornea becomes inflamed due to an invasive fungal infection, remains difficult to treat due in part to limited choices of available treatments. Topical eye drops are first-line treatment, but can be ineffective as low levels of drug reach the target site due to precorneal losses and the impenetrability of the cornea. The aim of this study was to determine the corneal delivery of econazole using a novel topical enhancement approach using a composite delivery system based upon cyclodextrins and soft hydrogel contact lenses. Excess econazole nitrate was added to hydroxypropyl-α-cyclodextrin (HP-α-CD) and hydroxypropyl-β-cyclodextrin (HP-β-CD) solutions, and the solubility determined using HPLC. Proprietary soft hydrogel contact lenses were then impregnated with saturated solutions and applied to freshly enucleated porcine eyeballs. Econazole nitrate ‘eye drops’ at the same concentrations served as the control. After 6 h, the corneas were excised and drug-extracted, prior to quantification using HPLC. Molecular dynamic simulations were performed to examine econazole–HP-β-CD inclusion complexation and dissociation. The minimum inhibitory concentration (MIC) of econazole was determined against four fungal species associated with keratitis, and these data were then related to the amount of drug delivered to the cornea, using an average corneal volume of 0.19 mL. The solubility of econazole increased greatly in the presence of HP-β-CD and more so with HP-α-CD (p < 0.001), with ratios >> 2. Hydrogel contact lenses delivered ×2.8 more drug across the corneas in comparison to eye drops alone, and ×5 more drug delivered to the cornea when cyclodextrin was present. Molecular graphics demonstrated dynamic econazole release, which would create transient enhanced drug concentration at the cornea surface. The solution-only drops achieved the least satisfactory result, producing sub-MIC levels with factors of ×0.81 for both Fusarium semitectum and Fusarium solani and ×0.40 for both Scolecobasidium tshawytschae and Bipolaris hawaiiensis. All other treatments delivered econazole at > MIC for all four fungal species. The efficacies of the delivery platforms evaluated were ranked: HP-α-CD contact lens > HP-β-CD contact lens > contact lens = HP-α-CD drops > HP-β-CD drops > solution-only drops. In summary, the results in this study have demonstrated that a composite drug delivery system based upon econazole–HP-β-CD inclusion complexes loaded into contact lenses can achieve significantly greater corneal drug delivery with the potential for improved clinical responses.

An automatic drug injection device with spatial micro-force perception guided by an microscopic image for robot-assisted ophthalmic surgery.

Retinal vein injection guided by microscopic image is an innovative procedure for treating retinal vein occlusion. However, the retina organization is complex, fine, and weak, and the operation scale and force are small. Surgeons’ limited operation and force-sensing accuracy make it difficult to perform precise and stable drug injection operations on the retina in a magnified field of image vision. In this paper, a 3-DOF automatic drug injection mechanism was designed for microscopic image guiding robot-assisted needle delivery and automatic drug injection. Additionally, the robot-assisted real-time three-dimensional micro-force-sensing method for retinal vein injection was proposed. Based on the layout of three FBG sensors on the hollow outer wall of the nested needle tube in a circular array of nickel-titanium alloys, the real-time sensing of the contact force between the intraoperative instrument and the blood vessel was realized. The experimental data of 15 groups of porcine eyeball retinal veins with diameters of 100–200 μm showed that the piercing force of surgical instruments and blood vessels is 5.95∼12.97 mN, with an average value of 9.98 mN. Furthermore, 20 groups of experimental measurements on chicken embryo blood vessels with diameters of 150–500 μm showed that the piercing force was 4.02∼23.4 mN, with an average value of 12.05 mN.

Ultrawide Bandwidth High-Frequency Ultrasonic Transducers With Gradient Acoustic Impedance Matching Layer for Biomedical Imaging.

The high-frequency ultrasonic transducers with larger bandwidths yield excellent imaging performance in the biomedical field. However, achieving perfect acoustic impedance matching from the piezo-element to the target medium in the operating frequency spectrum is still a challenge. Conventional matching layers are mostly fabricated by only one or two uniform materials which are limited by their acoustic property. We propose a novel composite matching layer with gradient acoustic impedance based on a 1-3 gradient composite structure and multilevel matching theory. The proposed gradient-composite matching layer applied for ultrasonic transducer provides efficient impedance matching and ultrawide bandwidth which can significantly improve the quality of biomedical imaging. The active aperture size of the matching layer is 5× 5 mm2, and the overall thickness for five equivalent layers is 115 [Formula: see text]. The -6-dB bandwidth and the center frequency obtained by the ultrasonic transducer equipped with the 1-3 gradient composite matching layer are 141.7% and 22.3 MHz, respectively. The exceedingly good imaging performance of the fabricated ultrasonic transducer was demonstrated by the tungsten wire phantom and study on the biological tissues of a zebrafish and porcine eyeball. The theoretical and experimental results provide a novel train of thought for improving the quality of biomedical ultrasonic imaging.

Eye orbit effects on eyeball resonant frequencies and acoustic tonometer measurements

The eye orbit has mechanical and acoustic characteristics that determine resonant frequencies and amplify acoustic signals in certain frequency ranges. These characteristics also interfere with the acoustic amplitudes and frequencies of eyeball when measured with an acoustic tonometer. A model in which a porcine eyeball was embedded in ultrasonic conductive gel in the orbit of a model skull was used to simulate an in vivo environment, and the acoustic responses of eyeballs were detected. The triggering source was a low-power acoustic speaker contacting the occipital bone, and the detector was a high-resolution microphone with a dish detecting the acoustic signals without contacting the cornea. Dozens of ex vivo porcine eyeballs were tested at various intraocular pressure levels to detect their resonant frequencies and acoustic amplitudes in their power spectra. We confirmed that the eyeballs’ resonant frequencies were proportional to intraocular pressure, but interference from orbit effects decreased the amplitudes in these resonant frequency ranges. However, we observed that the frequency amplitudes of eyeballs were correlated with intraocular pressure in other frequency ranges. We investigated eye orbit effects and demonstrated how they interfere with the eyeball’s resonant frequencies and frequency amplitudes. These results are useful for developing advanced acoustic tonometer.

Better safe than sorry? Results from an ex-vivo study demonstrate that the thulium fiber laser may cause eye injury without standard protection.

We conducted a study using an ex-vivo porcine model to evaluate whether a thulium fiber laser (TFL) induces ocular injury in the context of inadvertent exposure to the laser beam. A 365 μm TFL was positioned at a set distance (0 cm, 5 cm, 8 cm, and 10 cm) from a freshly harvested (<12 hours) porcine eyeball and the laser was activated for one second at select laser settings for lithotripsy (0.2 J at 50 Hz, 0.5 J at 20 Hz, and 1 J at 10 Hz) and soft tissue ablation (2 J at 10 Hz, 1 J at 50 Hz). The experiment was repeated with laser safety goggles and prescription eyeglasses. Thermal injury was assessed by histopathological analysis. Without eye protection, corneal injury was observed even at 10 cm away for one lithotripsy setting (1 J at 10 Hz) and both tissue ablation settings. All thermal injuries observed were superficial only, except for at 0 cm distance, where deep-layer injury was observed. Laser safety goggles offered complete protection regardless of setting or distance. Partial protection was demonstrated with prescription glasses: histopathological damage was observed for both soft tissue ablation settings and only at 0 cm for two lithotripsy settings (0.5 J at 20 Hz, 1 J at 10 Hz). The TFL can induce ocular injury at close distances and at higher power settings. The use of laser safety goggles confers complete protection while prescription eyeglasses confer partial protection. Further study is warranted.

Morphological analysis of cell distribution and network structure via gap junctions in swine corneal stroma.

Because of corneal transplantation limitations, there is a need for cornea-specific regenerative medicine. The development of such regenerative medicine has been delayed because of the complex and unique structure of the corneal stroma. Few studies have explored the corneal stroma cell distribution and cell types in vivo. This study investigated regional differences in morphological characteristics and distributions of corneal keratocytes and immunocompetent cells in the corneal stroma to clarify their functions and structural characteristics. The porcine eyeballs were subjected to light microscopy, transmission electron microscopy, scanning electron microscopy, and immunofluorescence staining analyses. Corneal cells were primarily located in the limbus, rather than the center of the cornea; the long keratocyte diameter was largest on the epithelial side of the corneal limbus, while the short diameter was largest on the endothelial side of the central cornea. Moreover, there were significantly more corneal cells on the epithelial side than on the endothelial side in both the central and limbus areas. Gap junctions between cells in the corneal stroma were present on the surfaces of cytoplasmic processes. Many cytoplasmic processes were scattered throughout the corneal stroma; they were connected both vertically and horizontally, forming an intercellular network. Additionally, immunocompetent cells on the epithelial side suggested to participate in this network via gap junctions. The morphology of keratocytes and immunocompetent cells on the epithelial side suggests that they play important roles in corneal homeostasis.

Dry physical crosslinking of porcine corneal grafts. In vitro study

AbstractPurpose(1) To compare the effects of wet and dry crosslinking (CL) on swell‐resistance of porcine corneal grafts; (2) for grafts obtained by dry physical CL methods, to evaluate some of their surgically relevant properties.MethodsExperiment 1. The cornea was cut out of a frozen porcine eyeball with epithelium and Descemet's membrane removed. 30 such grafts were distributed into 10 groups of treatment (3 per group): five groups of wet grafts (wet control; Riboflavin/ultraviolet‐A CL at doses 5.4 and 54 J/cm2; glutaraldehyde CL at concentrations 0.1 and 1%) and five groups of air‐dried grafts (dry control; ultraviolet‐C (UVC) at doses of 5.4 and 54 J/cm2; dehydrothermal (DHT) CL at 80 and 105 °C). All grafts were immersed in distilled water for 24h, then their light transmission and swelling ratio were measured.Experiment 2. 18 grafts (6 groups: wet non‐hydrated control; wet control; dry control; UVC 54 J/cm2; DHT 105°C; DHT 105°C + UVC 54 J/cm2) were immersed in water for 24 hr, then distant visual quality at 5 m, central thickness (CT) and suture retention strength (SRS) were tested. ANOVA and post‐hoc Tukey HSD tests were used.ResultsExp. 1. There was a significant difference in water content and light transmission between all groups at 24h hydration (p &lt; 0.05, ANOVA). DHT 105°C grafts had significantly lower water content and the highest light transmission in comparison to all other groups (p &lt; 0.05 for each comparison, Tukey HSD).Exp. 2. At 24 hr hydration, DHT+UVC treated grafts allowed distinguishing optotypes 0.4–0.6 (decimal). CT varied from 600 to 1200 microns for DHT+UVC and UVC groups, respectively. Control grafts swelled up to 6000 microns in the center. SRS of all grafts was significantly higher than the strength of the Nylon 9‐0 thread (p&lt;0.05, Tukey HSD).ConclusionsDry physical CL methods allow obtaining corneal grafts with increased swell‐resistance compared to wet CL methods, while maintaining the strength sufficient for their surgical fixation.

Real-time measurement of intraocular pressure variation during automatic intravitreal injections: An ex-vivo experimental study using porcine eyes.

PurposeTo measure needle insertion force and change in intraocular pressure (IOP) in real-time during intravitreal injection (IVI). The effects of needle size, insertion speed, and injection rate to IOP change were investigated.MethodsNeedle insertion and fluid injection were performed on 90 porcine eyeballs using an automatic IVI device. The IVI conditions were divided according to needle sizes of 27-gauge (G), 30G, and 33G; insertion speeds of 1, 2, and 5 mm/s; and injection rates of 0.01, 0.02, and 0.05 mL/s. Insertion force and IOP were measured in real-time using a force sensor and a pressure transducer.ResultsThe peak IOP was observed when the needle penetrated the sclera; the average IOP elevation was 96.3, 67.1, and 59.4 mmHg for 27G, 30G, and 33G needles, respectively. An increase in insertion speed caused IOP elevation at the moment of penetration, but this effect was reduced as needle size decreased: 109.8–85.9 mmHg in 27G for 5–1 mm/s (p = 0.0149) and 61.8–60.7 mmHg in 33G for 5–1 mm/s (p = 0.8979). Injection speed was also related to IOP elevation during the stage of drug injection: 16.65 and 11.78 mmHg for injection rates of 0.05 and 0.01 mL/s (p < 0.001).ConclusionThe presented data offers an understanding of IOP changes during each step of IVI. Slow needle insertion can reduce IOP elevation when using a 27G needle. Further, the injection rate must be kept low to avoid IOP elevations during the injection stage.

Design and research of a robotic system for ultrasonic‐assisted lamellar keratoplasty

In order to solve the problem of uncontrollable cutting depth and the rough incision edge of the cornea with manual trephine in lamellar keratoplasty, an ultrasonic-assisted corneal trephination method has been proposed for the first time in accordance with the advantage of ultrasonic vibration cutting, and the corresponding robotic system has been designed and researched. According to the traditional process of lamellar keratoplasty, the requirements of the surgical robotic system were first proposed. On this basis, the robotic system was designed and its schematic diagram was introduced. Second, the key components of the robotic body such as the eccentric adjusting mechanism and the end-effector of ultrasonic scalpel were illustrated, which can realise corneal trephination of different incision diameters without scalpel replacement. Then the operation flow chart of a robot-assisted lamellar keratoplasty was put forward. Finally, the preliminary verified experiments were performed using a grape and a porcine eyeball, respectively, in vitro with the prototype system. The results show that the robotic system can basically satisfy the operation requirements of lamellar keratoplasty. Owing to the less cutting force and smoother corneal incision edge of ultrasonic-assisted lamellar keratoplasty compared with manual trephine, it was proved to be more feasible and superior.

Effects of hydrogen peroxide solution on the biomechanics of porcine cornea.

To determine the biomechanical changes of porcine corneas after the application of hydrogen peroxide(H2O2) solution. Fifty-five porcine eyeballs with similar sizes were divided into 11 groups based on the H2O2 application. The eyeballs were treated with the following concentrations of H2O2 solution: 1 mol/L, 500 mmol/L, 250 mmol/L, 125 mmol/L, 62.5 mmol/L, 31.25 mmol/L, 15.63 mmol/L, 7.81 mmol/L, 3.91 mmol/L, 0.9% saline, or blank. The eyeballs were immersed into the solution for 30 min. The biomechanics of each cornea in the different groups was determined soon after the indentation and tensile tests. We calculated the average Young's modulus of the different groups to determine the effects of H2O2 solution on porcine corneas. The comparison between the groups was conducted using ANOVA analysis. Moreover, the safety of each concentration of H2O2 solution on the corneal tissues was determined by histopathological examination. The Young's modulus was significantly different among all the groups (p = 0.003). The modulus was the highest in the group treated with 3.91 mmol/L H2O2 and it was significantly different from that in the group treated with 0.9% saline or the blank group, for both the indentation and tensile tests. Histopathological examination showed that H2O2 at a concentration of ⩾62.5 mmol/L damaged the epithelium, stroma, or both, while H2O2 at a concentration ⩽31.25 mmol/L did not change the morphology of the epithelium or stroma. Treatment with 3.91 mmol/L H2O2 solution can safely and effectively increase the biomechanical strength of the cornea.

A pilot study for intraocular pressure measurements based on vibroacoustic parameters

The present study aimed to identify vibroacoustic properties associated with intraocular pressure (IOP) changes and to suggest a new way to measure the IOP based on these properties. Ten ex vivo porcine eyeballs were used in this study. Each eyeball was fixated in a central hole of a Styrofoam block, and vibration applied to the Styrofoam block was transmitted to the eyeball. An accelerometer directly attached to the eyeball measured the vibration response. Excitations and measurements were performed for 1 s, and the excitation magnitude was varied for the same signal in repeat measurements. A 30-gauge needle was inserted into the anterior chamber of the eyeball to inject a balanced salt solution, and the height of the bottle was adjusted to adjust the IOP. A tonometer was used under identical conditions to measure the IOP five times, and the mean value was determined for further analyses. The measurements showed that the parameters resonance frequency and change in the magnitude of the vibration response (CMVR) increased with rising IOP values. The CMVR was highly correlated with the IOP (p-value < 0.0001). A linear mixed effects model (LMM) was used as a statistical analysis method. We confirmed that vibroacoustic properties of the eyeball are correlated with IOP changes. It is expected that the CMVR will serve as a new parameter for IOP measurements. Thus, in the future, continuous IOP measurements would be easily performed using the CMVR.