Corneal Transplantation Clinical Trial
Official title:
Prospective Study of Deep Anterior Lamellar Keratoplasty Using Acellular Porcine Cornea
The performance of keratoplasty is hampered by the limited availability of donor cornea in
many countries, especially in Asia. For this reason, attempts have been made to fabricate
artificial substitutes for natural human cornea. So far, all polymeric biomaterials, such as
collagen configurations and plastic compression, could mimic the functional optically
transparent but failed to replicate the complicate three-dimension microstructure of natural
cornea. Therefore, despite some favorable results yielded by polymeric biomaterials, they
cannot be suited for long-term use. To overcome these disadvantages, in recent years,
porcine cornea appeared specifically attractive for xenotransplantation, because of its
accessibility and similarities to natural human cornea. However, xenotransplantation using
fresh porcine cornea can occurs hyperacute immune rejection, resulting in graft failure.
Such transplant rejection can be substantially lessened by using acellular porcine cornea
(APC), which preserves the constructure of natural cornea, whilst having well
biocompatibility and low antigenicity. These properties feature APC particularly suitable
for high-risk keratoplasty, such as corneal grafting in infectious keratitis.
Use of APC in LK has been shown promise in many preclinical animal studies and initially in
human clinic trail. However, to optimize APC biological and biomechanical properties, the
strategies for its preparation has evolved extensively over recent years, like various
decellularization approaches (e.g. detergents, enzymes, human sera, hypertonic solutions and
et al) and additional procedures (e.g. collagen re-crosslinking and repeated frozen-dry).
Therefore, in the current study, the investigators analyzed the early surgical outcomes of
deep anterior lamellar keratoplasty (DALK) using the APC that was very recently approved by
the National Institutes for Food and Drug Control (NIFDC) of China for clinic practice, for
management of infective keratitis, including fungal, viral and acanthamoeba keratitis. Here
major concern of this study was to clarify the behavior of APC after implantation in
participants.
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