麻省理工大学：《生物材料——组织交互作用》教学讲义（英文版）B Conjunctiva synthesis in vivo

B Conjunctiva synthesis in vivo( regeneration) 1. Structure and function of conjunctiva 2. Clinical effects of conjunctival scarring 3. Anatomically well-defined defect 4. Synthesis of conjunctival stroma, followed by re - epithelialization

B. Conjunctiva synthesis in vivo (regeneration) 1. Structure and function of conjunctiva. 2. Clinical effects of conjunctival scarring. 3. Anatomically well-defined defect. 4. Synthesis of conjunctival stroma, followed by re-epithelialization

article handed out Inhibition of Conjunctival Scarring and Contraction by a porous collagen-Glycosaminoglycan Implant Hsu et aL, in Investigative Ophthalmology and visual science 41: 2402-2411

article handed out Inhibition of Conjunctival Scarring and Contraction by a Porous Collagen-Glycosaminoglycan Implant Hsu et al., in Investigative Ophthalmology and Visual Science 41:2402-2411

1 Structure and function of the conjunctiva The conjunctiva covers the exposed part of the scleraopaque part of eye)and the inner surface of the eyelids The epithelial tissue is stratified and contains goblet cells in the surface layers Goblet cells synthesize and secrete mucus that contributes to the protective and lubricating layer on the exposed surface of the eye Underneath the epithelial tissue is the conjunctival stroma, a loose vascular supportive tissue

1. Structure and function of the conjunctiva The conjunctiva covers the exposed part of the sclera (opaque part of eye) and the inner surface of the eyelids. The epithelial tissue is stratified and contains goblet cells in the surface layers. Goblet cells synthesize and secrete mucus that contributes to the protective and lubricating layer on the exposed surface of the eye. Underneath the epithelial tissue is the conjunctival stroma, a loose vascular supportive tissue

2 Clinical effects of conJunctIval scarring Spontaneous healing of deep wounds in the conjunctiva occurs by contraction, scar formation and re-epithelialization Conjunctival scarring is common endpoint for several opthalmic disorders, resulting from infection(trachoma), traumatic (chemical burns) and surgical (pterygium causes

2. Clinical effects of conjunctival scarring • Spontaneous healing of deep wounds in the conjunctiva occurs by contraction, scar formation and re-epithelialization. • Conjunctival scarring is common endpoint for several opthalmic disorders, resulting from infection (trachoma), traumatic (chemical burns) and surgical (pterygium) causes

Anatomy of the conjunctiva Fornix Eyelid Cornea Epitheli pi um Sclera Conjunctival stroma

Anatomy of the conjunctiva Fornix Eyelid Cornea Sclera Epithelium Substantia Propria Conjunctival stroma

3. Anatomically well-defined defect Defect: Excise complete epithelia and stroma Spontaneous healing: Full-thickness defect in conjunctiva heals by contraction and scar synthesis

3. Anatomically well-defined defect Defect: Excise complete epithelia and stroma. Spontaneous healing: Full-thickness defect in conjunctiva heals by contraction and scar synthesis

Conjunctiva wound model Conjunctiva Scaffold dRt Tenons capsule Sclera

Conjunctiva wound model Conjunctiva Tenon’s capsul e Sclera Sclera Scaffold D R T Sutures

4. Synthesis of conjunctival stroma, followed by re epithelialization Sequential synthesis (as for skin) Synthesize stroma using dermis regeneration template(RT) Epithelial tissue spontaneously synthesized over new stroma

4. Synthesis of conjunctival stroma, followed by re￾epithelialization Sequential synthesis (as for skin): Synthesize stroma using dermis regeneration template (DRT). Epithelial tissue spontaneously synthesized over new stroma

Effect of DRT on contraction kinetics of conjunctival defect. It is experimentally convenient to study contraction of the fornix a tissue attached to the conjunctiva ungrafted Ec 万 15 grafted with scaffold DRT 15 Days Hsu et al 2000

Effect of DRT on contraction kinetics of conjunctival defect. It is experimentally convenient to study contraction of the fornix, a tissue attached to the conjunctiva. ungrafted grafted with scaffold DRT 30 % Fornix Shortening 15 0 0 15 30 Days Hsu et al., 2000

14 days epithelialization ungrafted (red) of scar(blue) Image removed due to copyright considerations See Figure 6 in [Hsu 2000] epithelialization grafted with DRT (red) of incipient new dermis (blue)

14 days epithelialization (red) of scar (blue) ungrafted Image removed due to copyright considerations. See Figure 6 in [Hsu 2000] Image removed due to copyright considerations. See Figure 6 in [Hsu 2000] epithelialization (red) of incipient new dermis (blue) grafted with DRT