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Intrastromal implantation of chicken corneal grafts into the cornea of rabbits for corneal thickening: an experimental study

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Abstract

Purpose

To evaluate the feasibility and effects of the intrastromal implantation of chemically modified corneal stroma obtained from chicken into the corneas of rabbits for corneal thickening.

Methods

Chicken corneas were cut, debrided, treated with cross-linking and implanted in an intrastromal pouch created in the cornea of 10 white New Zealand rabbits with femtosecond laser. Slit-lamp biomicroscopy and optical coherence tomography were performed immediately, 7, 30 and 90 days postoperatively. Corneas were removed at 90 days and cut in two halves. One half was sent to histological analysis for the presence of necrosis, polymorphonuclear inflammatory cells, blood vessels and fibrosis, while the other half was evaluated with transmission electron microscopy to verify tissue organization and the presence of keratocytes and inflammatory cells. Corneal thicknesses were comparatively analyzed over time with Wilcoxon test (p ≤ 0.05).

Results

The chicken grafts were incorporated into the cornea of all animals over time. Mean rabbit cornea thickness increased from 338 µm preoperatively to 538 µm (p < 0.0077) at 90 days, while mean chicken graft thickness decreased from 350 to 215 µm (p < 0.0077). No clear signs of rejection attributable to the xenograft were observed in any of the implanted eyes. However, some macroscopic and histological events were observed in some of the eyes, probably due to procedural issues during implantation.

Conclusion

The intrastromal implantation of chicken grafts was shown to be feasible and predictable to thicken the recipient rabbit cornea without apparent rejection. However, before being considered in humans, further meticulous clinical trials are required to establish the clinical utility, safety and efficacy of xenografts for the treatment of patients with advanced keratoconus.

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Acknowledgements

The authors would like to express their gratitude to Mr. Antonio Carlos Correa for reviewing the English version of the paper.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Provisão Hospital de Olhos de Maringá, Rua Silva Jardim, Nº 359, Maringá, 87013-010, Brazil

    Flavia Motta Almodin, Juliana Motta Almodin & Edna Motta Almodin

  2. Santa Casa de São Paulo Medical School, Rua Dr. Cesário Mota Junior, 112 - Vila Buarque, São Paulo, 01221-020, Brazil

    Flavia Motta Almodin & Antonio Gonçalves

  3. State University of Maringá, Av. Colombo, 5790 - Jd. Universitário, Maringá, 87020-900, Brazil

    Nilma Fernandes

  4. Clínica de Olhos Dr. Paulo Ferrara, Av. Contorno, 4747 - Bairro Serra, Belo Horizonte, 30110-921, Brazil

    Paulo Ferrara

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  1. Flavia Motta Almodin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by FA, JA and EA, and NF under the supervision of PF and AG. The first draft of the manuscript was written by FA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Flavia Motta Almodin.

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The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed were in accordance with the ethical standards of the institution at which the studies were conducted and ethical approval was obtained from Animal Research Ethics Committee of Ingá Animal Medical School (UNINGA), Maringá, Brazil (No. PM 06/2017). The procedures used in this study adhere to the criteria recommended by the Brazilian College of Animal Experimentation (COBEA) and the ARRIVE Guidelines for Reporting Animal Research.

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Almodin, F.M., Almodin, J.M., Almodin, E.M. et al. Intrastromal implantation of chicken corneal grafts into the cornea of rabbits for corneal thickening: an experimental study. Int Ophthalmol 41, 243–255 (2021). https://doi.org/10.1007/s10792-020-01573-4

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