Incorporation of a fluorocarbon polymer implanted at the posterior surface of the rabbit cornea

An implant of porous expanded polytetrafluoroethylene (PTFE) in the corneal stroma allows fast cell colonization and can become translucent. We studied the behavior of the same polymer implanted in the anterior chamber of the rabbit eye and sutured to the posterior surface of the cornea. The expanded tetrafluoroethylene was provided as 200-micron thick sheets in 3 pore diameters (20, 50 and 80 microns). Disks (5 mm) were implanted in the anterior chambers of 20 rabbits and sutured to the posterior surface of the cornea. Histological and ultrastructural studies were performed after 3 and 4 months. Quantimetry was done on TEM images to analyze the fibrillar structure of the intercellular matrix inside and around the implanted polymer. The material was well tolerated. In all cases there was mild central corneal edema, which disappeared after 1 month. Mild neovascularization occurred in five cases, decreasing after 1 month. The polymer became translucent after 8 days. Keratocytes from the corneal stroma colonized the implant via breaks in the Descemet's membrane along the sutures. Quantimetry showed three types of fibrils inside and beside the polymer. Corneal endothelial cells regenerated over the fibroblasts and the polymer. This fluorocarbon polymer implanted in the anterior chamber and sutured to the posterior surface of the cornea was well tolerated, and there was real incorporation, with keratocytes producing collagen fibrils inside the polymer and endothelial cells forming a posterior cell monolayer. This is promising for the development of a keratoprothesis with posterior fixation.