Minimally Invasive Keratoprosthesis

项目摘要 这项资助申请的目的是培训查尔斯·于博士的科学技能和必要的知识 作为一名独立的科学家，将科学发现转化为临床有用的应用， 特别是角膜盲患者的视力恢复。除了主要目标之外， 培训余博士成为一名独立的研究者，这个计划可能会产生重大影响， 通过开发新的角膜置换技术治疗角膜失明。 候选 博士Yu是一位受过奖学金培训的眼科医生，专门研究角膜失明，并对 开发新技术来治疗失明他是角膜神经支配方面的专家， 角膜和眼病动物模型、眼部感染和屈光手术临床试验。他有一 在基础科学的强大背景下完成了许多研究项目和霍华德休斯 医学研究所赞助的医学研究奖学金。他目前是助理教授和K12 伊利诺伊大学眼耳医院的学者。在这段时间里，他将多次 工程和材料科学课程，并完成两次实习，以发展他在聚合物方面的技能 化学和工业设计。 环境 伊利诺伊大学眼耳医院是美国最大的视觉研究中心之一， 在上一个财政年度的NIH资助中排名前四。该系共有47名全职教师， 其中24人从事基础科学或转化研究。该研究计划包括 视觉研究的最关键领域，包括对致盲原因和病理学的调查 疾病，开发诊断和监测疾病的创新技术和仪器， 眼科疾病的进展，视网膜疾病和视觉功能的全基因组关联研究， 视网膜突起该部门承诺超过22，000平方英尺的物理空间用于研究。 研究 角膜包括眼睛的外前层。正常的角膜是透明和弯曲的， 来自外部世界的光。当因疾病或功能障碍而受伤时，角膜变得不透明， 光散射和视觉功能丧失。在角膜干细胞受损或 如果没有足够的血管供应，由于排斥的风险，不能进行移植。目前，在这种情况下，波士顿 可以进行人工角膜I型（BKpro）。5年成功率为50-70%，取决于 study. 然而，BKpro仍然受到其技术难度和并发症发生率的限制，如挤压，感染， 特别是膜形成和青光眼。这些并发症的发生率高达65%， 分别为76%。目前对于假体膜形成的原因以及 在这些患者中，尽管施加压力， 调节青光眼引流装置。此外，设计进步也有可能降低 手术植入和对供体角膜组织的需求。这项研究提出了一个简单的发展， 植入式微创人工角膜（MiKpro）装置，可通过 3 mm环钻术，不使用供体角膜组织。 这项研究提供了研究导致人工角膜并发症的病理生理学的机会 并创造一种有用的角膜替代物，其可以通过小伤口植入， 供体角膜组织

Project Abstract The objective of this grant application is to train Dr. Charles Yu in the scientific skills and knowledge necessary for a career as an independent scientist translating scientific discoveries to clinically useful applications, specifically the restoration of vision in patients with corneal blindness. In additional to the primary goal of training Dr. Yu to become an independent investigator, this program may have a significant impact on the treatment of corneal blindness through the development of a new corneal replacement technology. Candidate Dr. Yu is a fellowship trained ophthalmologist specializing in corneal blindness and has a deep interest in developing new technologies to cure blindness. He is an expert in corneal innervation, developing artificial corneas and animal models of eye disease, ocular infections, and refractive surgery clinical trials. He has a strong background in the basic sciences having completed numerous research projects and a Howard Hughes Medical Institute sponsored medical research fellowship. He is currently an assistant professor and a K12 scholar at the University of Illinois Eye and Ear Infirmary. During this training period he will take numerous courses in engineering and materials science and complete two internships to develop his skill in polymer chemistry and industrial design. Environment The University of Illinois Eye and Ear Infirmary is one of the largest centers of vision research in the US, ranking top 4 in NIH funding in the last fiscal year. The department has a total of 47 full time faculty members, with 24 of them engaged in basic science or translational research. The research program encompasses the most critical areas of vision research, including investigations into the causes and pathology of blinding diseases, the development of innovative techniques and instruments for diagnosing and monitoring the progression of eye disease, genome-wide association studies of retinal diseases and visual functioning and retinal processes. The department commits over 22,000 square feet of its physical space to research. Research The cornea comprises the outer anterior layer of the eye. A normal cornea is transparent and curved, focusing light from the outside world. When injured by disease or dysfunction the cornea becomes opaque, causing scattering of light and loss of visual function. In cases where corneal stem cells have been damaged or there is vascularity, transplantation cannot be performed due to risk of rejection. Currently in these situations a Boston Keratoprosthesis Type I (BKpro) can be performed. The 5 year success rate varies from 50-70% depending on study. However BKpro remains limited by its technical difficulty and rate of complications such as extrusion, infection, and particularly membrane formation and glaucoma. These complications occur at a rate of up to 65% and 76%, respectively. There is a gap in the current understanding of why prosthetic membranes form and why there is often relentless membrane formation or glaucoma in these patients despite placement of pressure regulating glaucoma drainage devices. Also there is potential for design advances to reduce the complexity of surgical implantation and need for donor cornea tissue. This study proposes the development of a easy to implant minimally invasive keratoprosthesis (MiKpro) device, which can be implanted into the cornea through a 3 mm trephination without use of donor cornea tissue. This study offers the opportunity to both study the pathophysiology leading to keratoprosthesis complications and create a useful corneal replacement which can be implanted through a small wound and does not require donor corneal tissue.