Long-term follow-up of a supradescemetic keratoprosthesis in rabbits: An immunofluorescence study

Edgar M. Espana, Ana C. Acosta, Josef Stoiber, Viviana Fernandez, Peggy D. Lamar, Franck L. Villain, Emmanuel Lacombe, Eduardo Alfonso, Jean Marie Parel

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: To evaluate the long-term clinical and immunohistological outcome of two different non-penetrating keratoprosthesis (KPro) implanted in non-injured rabbit corneas. Materials and methods: Three rabbits underwent implantation of a pHEMA-MMA 34 synthetic cornea in the supradescemetic space, and PMMA synthetic corneas in the supradescemetic space and within the central stroma. Animals were followed for at least 24 months before euthanasia. Periodic evaluation was performed with slit-lamp examination and photography. At the end of the follow-up, histological examination including hematoxylin eosin staining and immunocharacterization against collagen IV, alpha smooth muscle actin (α-SMA) and macrophages was performed. Results: The pHEMA-MMA 34 implant was not extruded, and remained transparent until the end of follow-up. This material did not induce any cell infiltration, corneal scarring or tissue remodeling in the surrounding stroma as shown by immunofluorescence. In contrast, synthetic corneas made of PMMA-induced myofibroblast differentiation, stromal remodeling and macrophage infiltration. This reaction was even more significant in the rabbit with the PMMA implant within the corneal stroma. Conclusion: pHEMA-MMA 34 was clinically biocompatible, and did not induce any inflammatory reaction or scarring when implanted in the supradescemetic space. This material showed more promising biocompatibility results than for PMMA, whether implanted within the central cornea stroma or in the supradescemetic space.

Original languageEnglish (US)
Pages (from-to)253-260
Number of pages8
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number2
StatePublished - Feb 2011


  • Biomaterials
  • Keratocytes
  • Keratoprosthesis
  • Myofibroblasts
  • Rabbits

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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