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Cornea and Ocular Surface
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Proof-of-concept study of electrospun PLGA membrane in the treatment of limbal stem cell deficiency
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  • Published on: 14 August 2021
    How to tame synthetic biodegradable materials in ophthalmology: the importance of medications An opinion from physiological viewpoints

    I read with interest the publication by Ramachandran et al, and offer the following comments.

    Synthetic Bioresorbable polyglycolic acid (PGA) sheets are widely used in surgery and have recently been applied to ulcers resulting from endoscopic submucosal dissection (ESD)in upper gastrointestinal endoscopy treatment[1]. In vivo, PGA sheets undergo nonenzymatic hydrolysis with the resulting glycolic acid being completely metabolized in about 15 weeks. Animal and human studies have shown that PGA implantation provokes acute and prolonged inflammation by foreign-body reaction and localized acidification. In only a few hours, degraded PGA and glycolic acid induce acute inflammation, as demonstrated by neutrophil infiltration [2].

    In the Ramachandran study, the safety of poly- lactic co- glycolic acid (PLGA) electrospun membranes as carriers for limbal tissue explants was demonstrated. The ocular surface remained clear with no epithelial defects in three in five subjects at 12 months. It should be noted that degradation of biosynthetic materials including PLGA triggers inflammatory reactions. Thereore in the package instructions and guidelines often recommends not to use these materials in ophthalmology. However, host inflammatory reactions could be controlled with adequate medications such as topical or systemic steroid administrations. Although in the article, no information on such medications was provided,I hope they would be providesd elsewhere. Then, The oph...

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    Conflict of Interest:
    None declared.