Minimally Invasive Keratoprosthesis

项目摘要 这项拨款申请的目的是训练余志强博士所需的科学技能和知识。 作为一名将科学发现转化为临床有用应用的独立科学家， 特别是角膜失明患者的视力恢复。除了以下主要目标之外 培养余博士成为独立调查员，这个项目可能会对 通过开发一种新的角膜置换技术治疗角膜失明。 侯选人 Yu博士是一位受过团契训练的眼科医生，专门研究角膜失明，并对 开发治疗失明的新技术。他是角膜神经支配方面的专家，研发人工角膜 眼部疾病、眼部感染和屈光手术的角膜和动物模型临床试验。他有一个 在基础科学方面有很强的背景，完成了许多研究项目，霍华德·休斯 医学研究所赞助了医学研究奖学金。他目前是一名助理教授和K12。 伊利诺伊大学眼耳医院的学者。在这段训练期间，他将接受许多 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力研究中心之一， 在上一财年排名NIH资金前4名。该系共有47名全职教职员工， 其中24人从事基础科学或翻译研究。这项研究计划包括 视力研究的最关键领域，包括对致盲原因和病理的调查 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。该部门承诺将超过22,000平方英尺的物理空间用于研究。 研究 角膜由眼睛的外前层组成。正常的角膜是透明的，弯曲的，聚焦的 来自外部世界的光。当因疾病或功能障碍而受伤时，角膜会变得浑浊，导致 光线散射和视觉功能丧失。在角膜干细胞受损或存在 由于有排斥反应的风险，不能进行血管移植。目前在这些情况下，一架波士顿 可以实施I型角膜假体(BKPRO)。5年成功率从50%到70%不等，具体取决于 学习。 然而，BKPro仍然受到其技术难度和挤出、感染、 尤其是膜形成和青光眼。这些并发症的发生率高达65%， 分别为76%。目前对人工膜形成的原因和原因的理解存在一个空白。 在这些患者中，尽管施加了压力，但通常会出现无情的膜形成或青光眼。 规范青光眼引流装置。此外，设计上的进步也有可能降低 手术植入并需要供体角膜组织。这项研究提出了一种易于开发的 植入性微创角膜假体(MiKpro)装置，可通过角膜植入 3 mm钻孔，不使用供体角膜组织。 这项研究为研究导致角膜假体并发症的病理生理学提供了机会 并创造出一种有用的角膜替代物，它可以通过一个小伤口植入，不需要 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.