Purpose: Patients with dry eye syndrome, Stevens-Johnson syndrome, or recurrent transplant rejections are unsuitable to receive a keratoprosthesis. The present work aims at developing a highly biocompatible keratoprosthesis that could be successfully implanted in such patients.
Methods: Glass-reinforced hydroxyapatite (GRHA) was used to construct this new artificial cornea. To grant the device an adequate porosity, a porogen agent was added in the following percentages: 10, 30, and 50%. Samples were physicochemically analyzed in terms of density, porosity, roughness, degradation, and surface imaging. Biological relevance was assessed by cell culture, MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrasodium bromide) assays, and cell imaging.
Results: Samples B (30% porogen) and C (50% porogen) were found to be the most porous and also had the roughest topography. Degradation studies showed that under simulated physiologic conditions, no mass loss was found. Conversely, under acidic conditions, a significant mass loss was found. The biological performance of these samples was satisfactory when cultured with human fibroblasts. The MTT assay revealed that samples B and C had greater propensity to cell invasion and proliferation than that of the other tested materials. Cell imaging demonstrated that fibroblasts organized around the pore edges before colonizing it.
Conclusions: A material with physicochemical and biological characteristics close to an ideal artificial cornea has been fabricated. The GRHA cornea containing 30% porogen is the most promising substitute material due to the biological performance, adequate porosity, and low degradation propensity.