Surface microgrooved xyloglucan tuned collagen xerogel for corneal stroma remodeling

Corneal ailments distorting the collagen fibrils of the stroma impair vision. Due to donor cornea shortage and the intrinsic limitations of synthetic materials, grafts resembling stromal microarchitecture are gaining attention. However, inferior mechanical properties, poor adhesion, and long-term instability of microstructural corneal grafts are challenges. In response, this study presents a xyloglucan-modulated human umbilical cord collagen-based xerogel (MX) that replicates the physiological attributes, transparency (85%), diffusivity, and proteolytic resistance of the native cornea. MX displays adequate tensile strength (6.34 MPa) and adhesiveness for surgical relevance. The sustained levofloxacin release from xerogels eliminates the need for topical eye drops. MX favours directional cell alignment, alleviates TGF-β1, vimentin, and CTGF, and elevates Keratocan and SMAD7 in human corneal stromal cells. In vivo MX engraftment following anterior lamellar keratoplasty in rabbits showed rapid re-epithelialization, restored corneal thickness (420 ± 21 μm) and curvature with no abnormal stromal reflectivity, and reduced corneal haze by 76.34% in 8 weeks. Histology studies revealed cellular distribution, integrity of corneal layers, reduced immunostaining for fibrosis markers, and spatial distribution of proteoglycans in MX-grafted eyes. Thus, micro-grooved xerogels are sufficiently robust for clinical settings, and their tissue reconstructive ability makes them a promising therapeutic for treating corneal stroma injury.