Page 338 - IJB-9-3

International Journal of Bioprinting

RESEARCH ARTICLE
Personalized 3D-printed amniotic fornical ring for

ocular surface reconstruction

Nan Zhang , Ruixing Liu , Xiaowu Liu, Songlin Hou, Runan Dou, Xingchen Geng,
†
†
Yan Li, Jingguo Li*, Lei Zhu*, Zhanrong Li*
Henan Eye Hospital, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University,
Zhengzhou 450003, China

Abstract

In the present work, we used three-dimensional (3D) printing technology to make
a polylactic acid (PLA) amniotic fornical ring (AFR) for ocular surface reconstruction.
This work is a retrospective and interventional case series of patients with ocular
surface diseases who underwent either personalized 3D-printed AFR-assisted
amniotic membrane transplantation (AMT) or sutured AMT (SAMT). Patient
epidemiology, treatment, operative duration, epithelial healing time, retention time,
vision changes, morbidity, and costs were analyzed. Thirty-one patients (40 eyes)
and 19 patients (22 eyes) were enrolled in the 3D-printed AFR group and the SAMT
group, respectively. The clinical indications of AFR and SAMT were similar, such as
† These authors contributed equally
to this work. corneal and/or conjunctival epithelial defects due to chemical burns, thermal burns,
Stevens–Johnson syndrome (SJS), or toxic epidermal necrolysis (TEN). The mean
*Corresponding authors: dissolution time was 15 ± 11 days in the AFR group, compared with 14 ± 7 days
Jingguo Li
(lijingguo@zzu.edu.cn) in the SAMT group. The percentage of healed corneal area was 90.91% (66.10%–
Lei Zhu 100.00%) for AFR and 93.67% (60.23%–100.00%) for SAMT. The median time for
(hnyks135@126.com) corneal epithelial healing was 14 (7–75) days in the AFR group and 30 (14–55) days
Zhanrong Li in the suture AMT group. There were no significant differences in the initial visual
(lizhanrong@zzu.edu.cn) acuity, final visual acuity, or improvement in visual acuity between the two groups.
Citation: Zhang N, Liu R, The operation duration in the AFR group was significantly shorter than that in the
Liu X, et al., 2023, Personalized SAMT group. Regarding the cost analysis, the average cost per eye in the AFR group
3D-printed amniotic fornical ring
for ocular surface reconstruction. was significantly lower than that in the SAMT group. Furthermore, 3D-printed and
Int J Bioprint, 9(3): 713. sterile AFR showed no obvious side effects on the eyes. Our results suggested that
https://doi.org/10.18063/ijb.713 3D-printed PLA scaffolds could be used as an AFR device for ocular surface disease. In
Received: November 24, 2022 addition, personalized 3D-printed AFR is superior to conventional AMT in operation
Accepted: January 26, 2023 duration and cost effectiveness, thereby reducing the financial burden on our health
Published Online: March 20, 2023 care system.
Copyright: © 2023 Author(s).
This is an Open Access article
distributed under the terms of the Keywords: 3D printing; Amniotic fornical ring; Amniotic membrane transplantation;
Creative Commons Attribution Ocular surface disease
License, permitting distribution
and reproduction in any medium,
provided the original work is
properly cited.
1. Introduction
Publisher’s Note: Whioce
Publishing remains neutral with The amniotic membrane (AM) from the innermost placenta is structurally divided into
regard to jurisdictional claims in three layers, including the epithelium, basement membrane, and mesenchymal layer.
published maps and institutional
[1]
affiliations. AMs without blood vessels exhibited low immunogenicity . Amniotic membrane

Volume 9 Issue 3 (2023) 330 https://doi.org/10.18063/ijb.713