TY - JOUR
T1 - Surface epithelialization of the type i Boston keratoprosthesis front plate
T2 - Immunohistochemical and high-definition optical coherence tomography characterization
AU - Kiang, Lee
AU - Rosenblatt, Mark I.
AU - Sartaj, Rachel
AU - Fernandez, Ana G.Alzaga
AU - Kiss, Szilard
AU - Radcliffe, Nathan M.
AU - D'Amico, Donald J.
AU - Sippel, Kimberly C.
N1 - Funding Information:
Acknowledgements This work was supported in part by an unrestricted departmental grant from Research to Prevent Blindness. L.K., a student of the Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, was supported by National Institute of Health Medical Scientist Training Program grant GM07739.
PY - 2012/8
Y1 - 2012/8
N2 - Background The aim of this work is to characterize a transparent tissue layer partially covering the anterior surface of the type I Boston permanent keratoprosthesis front plate in four patients. Methods The tissue over the front plate was easily scrolled back as a single transparent layer using a sponge. In two cases, histopathologic analysis was undertaken and immunofluorescent staining with a cytokeratin 3-specific antibody was performed. The relationship of the tissue to the keratoprosthesis device was further characterized using spectral domain highdefinition optical coherence tomography (HD-OCT). Results Histopathologic analysis revealed the tissue to be non-keratinized squamous epithelium. No goblet cells were seen, suggesting the cells were of corneal, and not conjunctival, epithelial origin. Immunofluorescent staining of all cells was positive for cytokeratin 3, a protein strongly associated with corneal epithelium. The tissue was easily discerned by HD-OCT and was of substantial thickness near the external junction between the keratoprosthesis device and the carrier corneal tissue. In three cases, visual acuity was unaffected by the presence or absence of this tissue. In one case, a prominent tissue margin temporarily obscured the visual axis and reduced visual acuity; this resolved with mechanical central debridement and has not recurred. Conclusions The transparent tissue layer covering the anterior surface of the type I Boston keratoprosthesis front plate was found to represent non-keratinized squamous epithelium, most likely of corneal epithelial origin. This potentially represents a further step in bio-integration of the keratoprosthesis device. In particular, epithelial coverage of the critical junction between the device and the carrier corneal tissue might serve an important barrier function and further reduce the incidence of infection and extrusion of the type I Boston permanent keratoprosthesis.
AB - Background The aim of this work is to characterize a transparent tissue layer partially covering the anterior surface of the type I Boston permanent keratoprosthesis front plate in four patients. Methods The tissue over the front plate was easily scrolled back as a single transparent layer using a sponge. In two cases, histopathologic analysis was undertaken and immunofluorescent staining with a cytokeratin 3-specific antibody was performed. The relationship of the tissue to the keratoprosthesis device was further characterized using spectral domain highdefinition optical coherence tomography (HD-OCT). Results Histopathologic analysis revealed the tissue to be non-keratinized squamous epithelium. No goblet cells were seen, suggesting the cells were of corneal, and not conjunctival, epithelial origin. Immunofluorescent staining of all cells was positive for cytokeratin 3, a protein strongly associated with corneal epithelium. The tissue was easily discerned by HD-OCT and was of substantial thickness near the external junction between the keratoprosthesis device and the carrier corneal tissue. In three cases, visual acuity was unaffected by the presence or absence of this tissue. In one case, a prominent tissue margin temporarily obscured the visual axis and reduced visual acuity; this resolved with mechanical central debridement and has not recurred. Conclusions The transparent tissue layer covering the anterior surface of the type I Boston keratoprosthesis front plate was found to represent non-keratinized squamous epithelium, most likely of corneal epithelial origin. This potentially represents a further step in bio-integration of the keratoprosthesis device. In particular, epithelial coverage of the critical junction between the device and the carrier corneal tissue might serve an important barrier function and further reduce the incidence of infection and extrusion of the type I Boston permanent keratoprosthesis.
KW - Bio-integration
KW - Corneal epithelium
KW - Keratoprosthesis
UR - http://www.scopus.com/inward/record.url?scp=84865809608&partnerID=8YFLogxK
U2 - 10.1007/s00417-012-1960-5
DO - 10.1007/s00417-012-1960-5
M3 - Article
C2 - 22371021
AN - SCOPUS:84865809608
SN - 0721-832X
VL - 250
SP - 1195
EP - 1199
JO - Graefe's Archive for Clinical and Experimental Ophthalmology
JF - Graefe's Archive for Clinical and Experimental Ophthalmology
IS - 8
ER -