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The use of porcine corneas for keratoplasty

February 14 2014
< div style = "text-align: left;"> In recent years, we have conducted experimental researchof potential use for keratoplasty porcine cornea as such, that in their morphological and immunological properties quite close to the human cornea. In developing krioliofilizovanogo keratoksenoimplantata that the Ministry of Health of Ukraine registered as a medical device « keratoksenoimplantat » (State registration number 9967/2010), is considered a long-term experience in manufacturing and clinical application krioliofilizovanoi skin (pigs) as ksenoimplantat for the treatment of patients mainly scalded. By the way if you are interested in.
The purpose of the study:provide ophthalmic practice plastic material based on krioliofilizovanogo keratoimplantata with corneal pigs for medical and tectonic keratoplasty with corneal ulcers of various etiologies.
In an experiment to study the effectiveness of pazlichnyh pig corneal preservation techniques were used such methods of preservation of donor corneas as moist chamber for VP Filatov, lyophilized drying, deep freezing (-196 C) without cryoprotectant, deep freeze with cryoprotectants and followed by lyophilization.
Experimental ksenokeratoplastika the procedure intralamelyarnoi keratoplasty was performed on 10 Vietnamese pigs and 10 rabbits chinchilla. Terms surveillance zhivotnymi- 6 months. Medical and therapeutic and tectonic keratoplasty keratoksenoimplantatom the procedure NA Puchkovskaya conducted on 10 patients withslozhneniyami inflammatory diseases of the cornea and 22 patients with burn injuries of the cornea. In 10 patients with inflammatory diseases of the cornea in 5 patients there was a complicated corneal ulcer perforation, 3 patients ulcer accompanied by the threat of corneal perforation (descemetocele) in two patients was complicated by corneal ulcer recursuyuschim keratouveitis. The majority of patients with burn injuries cornea ulcer had a total different depths, with the threat of perforation, in most cases accompanied by necrosis of the conjunctiva, so they were held medical tectonic keratoplasty with plastic conjunctiva and blefarorafieyu.

RESULTAta and discussion

developed and investigated the effectiveness of a number of methods of preserving pig corneas with limited antigenic activity. The parameters of the optimal conditions for the viability of corneal tissue by criteria histomorphological changes based on the use of differents cryopreservation methods for the subsequent establishment of the bank corneal xenografts. T
So, the study of different methods of preservation of the cornea revealed inherent fresh (unpreserved) underlying layers of tissue, cell performance front epiTelia, Bowman's membrane, stroma, Descemet's membrane and the endothelium under the conditions of cryopreservation in liquid nitrogen, especially pretreatment with cryoprotectant retained fully without visible signs of swelling or other damage.
In the oppositeawn this additional lyophilization cryopreserved corneas without cryoprotectant resulted in moderate or severe edema of the stroma to form the characteristic oval or rounded cavities, as well as cells of the anterior epithelium. These pathological changes may be offset by potentiation cryopreservation treatmenttissue substrate in cryoprotectant.
Without prejudice to the discussion of the mechanisms described features of the structural changes in the cornea according to the conservation, noting that the histomorphological and electronic research, it was found that it is better toprotected corneal structure with deep freezing cryoprotectant, and following lyophilization almost no effect on its structure. Thus, by combining the processing cryoprotective substrate corneal tissue by freezing and subsequent lyophilization opens prospects for achieving optimum properties bioimplantativ, reliablepreserve its properties during storage and transportation.
As a result of studying the characteristics of the reaction eye on the transplantation of xenogeneic corneas with different methods of preservation, followed by allograft into the cornea or xenotransplantation of piga rabbit cornea found that the reaction of the eye to the corneal allograft donor pig corneas pigs and reaction to rabbit cornea in the xenograft was negligible. In general, it was similar to that which occurs when a person intralamelyarny allotransplantation.
The positive results of an experimental study of morphological and biophysical properties ksenokeratoimplantatu as the basis for the next series of clinical use it in patients with ulcer complications of inflammatory diseases of the cornea and eye burns.
In-patient treatment after surgery, treatment and tectonic keratoplasty patients with ulcers corneas inflammatory etiology were up to 7 days. The postoperative period was characterized by a steady flow. Period of absorption ksenokeratoimplantatu usually lasted from 3 to 8 weeks. Complete healing of the ulcer is closeds to form a fistula corneal opacities in the defect area with moderate vascularization was achieved in all patients. All patients with burns of eyes managed to keep the cornea from perforation to save the eye and light perception with the prospect of further recovery of view.
Clinical and gistomorfologichnie study on the possibility of xenotransplantation of porcine corneas using the methods of conservation have shown that further donor cornea pigs can be recommended for the treatment and tectonic keratoplasty, as well as for long-term storage as an object of activity of the bank of tissuesThat could solve the problem of shortage of modern donor cornea.
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