Decellularized Human Sclera; an Optimized Biomaterial for Scleral Reconstruction

Area of Science:

• Ophthalmology
• Biomaterials Science
• Tissue Engineering

Background:

• Scleral damage requires surgical repair, with decellularization techniques offering a promising approach by preserving the extracellular matrix (ECM).
• Developing an optimized decellularization protocol for human sclera is crucial for effective tissue reconstruction.
• Evaluating acellular human sclera grafts in a rabbit model addresses scleral defects.

Purpose of the Study:

• To optimize a decellularization protocol for human sclera.
• To assess the safety and efficacy of acellular human sclera (HAS) grafts compared to native human sclera (HNS) in repairing scleral defects.
• To evaluate the structural integrity, biocompatibility, and healing potential of decellularized sclera.

Main Methods:

• Lamellar sclerectomy was performed on twelve rabbits, with defects grafted using HNS or HAS prepared via three distinct decellularization methods (A: SDS; B: SDS/Triton X-100; C: SDS/EDTA/Triton X-100/trypsin).
• Outcomes were evaluated through cell nucleus visualization, cytotoxicity assays, SDS residue analysis, structural integrity assessments, slit lamp examinations, AS-OCT imaging, and histopathology.
• Biodegradability and inflammatory responses were monitored throughout the study.

Main Results:

• All decellularization methods successfully removed cells while preserving ECM integrity, with Method C showing superior collagen preservation.
• Cytotoxicity was minimal, and SDS residues were reduced to safe levels.
• HAS grafts, particularly from Method C, demonstrated better biodegradability and resulted in thinner graft integration compared to HNS, with all patches effectively healing defects and showing consistent, manageable inflammation.

Conclusions:

• Decellularized human sclera is a suitable biomaterial for scleral reconstruction, effectively retaining ECM while eliminating cells.
• The developed decellularization protocols are robust and safe for repairing damaged scleral tissue.
• This optimized acellular human sclera holds significant potential for enhancing surgical outcomes in scleral reconstruction procedures.