Suture-Free Corneal Transplantation Via Bioself-Adhesive Lenticules Based On Macromolecular Electrostatic Entanglement
Published 2025 - 43rd Congress of the ESCRS
Reference: FP14.14 | Type: Free paper | DOI: 10.82333/2gac-4556
Authors: Mert Mestanoglu* 1 , Antonia Howaldt 1 , Nihan Demiralay 1 , Felix Bock 2 , Claus Cursiefen 3 , Björn Bachmann 1 , Mario Matthaei 1
1Department of Opthalmology,University of Cologne,Cologne,Germany, 2Department of Opthalmology,University of Cologne,Cologne,Germany;Center for Molecular Medicine Cologne (CMMC), University of Cologne,Cologne,Germany, 3Department of Opthalmology,University of Cologne,Cologne,Germany;Center for Molecular Medicine Cologne (CMMC), University of Cologne,Cologne,Germany;Cologne Excellence Cluster for Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne,Cologne,Germany
Purpose
Corneal lenticules extracted from small incision lenticule extraction (SMILE) are potential materials for corneal transplantation. However, due to their thickness limitations, they cannot be used for deep anterior lamellar keratoplasty (DALK). This study aims to explore a novel method to enhance the usability of corneal lenticules for suture-free transplantation, particularly in repairing deep corneal defects.
Setting
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University
Methods
The study investigates the electrostatic entanglement of oxidized chondroitin sulfate (O-CS), containing SO3- groups, with generation 4.0 polyamidoamine dendrimers (G4 PAMAM), containing NH2+ groups. This interaction forms a cohesive corneal lenticule transplantation module that can be used in suture-free corneal transplantation. The physical and biological properties of the module, including light transmittance, adhesion strength, and biocompatibility were analyzed using infrared spectroscopy, scanning electron microscopy, atomic force microscopy and live/dead staining. Animal studies were conducted in New Zealand white rabbits to evaluate the therapeutic effects of these modified lenticules in corneal defect repair.
Results
The electrostatic entanglement between O-CS and G4 PAMAM resulted in a corneal transplantation module with enhanced self-adhesion (33.80±2.12 kPa) and high light transmittance (>70%). The module also demonstrated excellent biocompatibility, which promotes stable adhesion over time. In vitro assays demonstrated that O-CS/G4 modified lenticules promoted HCSC viability, with no significant cytotoxicity. The immunofluorescence and western blotting results indicated positive modulation of corneal stromal cell phenotype. In vivo, the O-CS/G4-modified lenticules showed improved healing in corneal defects with enhanced transparency and collagen fiber alignment, as evaluated by slit-lamp microscopy, OCT, and histological staining.
Conclusions
This study demonstrates that electrostatic entanglement between macromolecules can enable suture-free corneal transplantation, offering a promising strategy for living tissue transplantation and wound repair. The developed corneal lenticule transplantation module holds potential for addressing deep corneal defects and enhancing clinical outcomes in corneal repair procedures.