{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:35:45Z","timestamp":1791261345917,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aimed to investigate the efficacy and safety of acellular porcine corneal stroma (APCS) for lamellar keratoplasty in the treatment of corneal ulcers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 14 patients (14 eyes) diagnosed with corneal ulcers who underwent lamellar keratoplasty using acellular porcine corneal stroma at the Second Affiliated Hospital of Nanchang University between June 2016 and May 2017 were recruited and followed up for at least 12\u202fmonths. Postoperative visual acuity, epithelial recovery, graft transparency, the recurrence rate of corneal ulcers, the rate of graft rejection, corneal neovascularization, graft infection, secondary glaucoma, and graft melting were examined and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 14 patients (100%) who underwent lamellar keratoplasty using acellular porcine corneal stroma successfully preserved the structure of their eyeballs. The visual acuity improved in 11 patients (78.5%). Graft rejection occurred in one patient (7.1%), while two patients (14.3%) developed recurrent corneal ulcers. Corneal vessel ingrowth was observed in seven patients (50%), and one patient (7.1%) developed pseudopterygium. The average time for complete epithelial recovery was 3\u20137\u202fdays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lamellar keratoplasty using acellular porcine corneal stroma is an effective surgical alternative for the treatment of corneal ulcers.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1534210","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:19:51Z","timestamp":1742195991000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Lamellar keratoplasty using acellular porcine corneal stroma for the treatment of corneal ulcers"],"prefix":"10.3389","volume":"12","author":[{"given":"Yiming","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenye","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youyang","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunwei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhirong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qifang","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"17281732","DOI":"10.3980\/j.issn.1672-5123.2019.10.21","article-title":"Bioengineered corneal transplantation for the treatment of infectious keratitis","volume":"19","author":"Lin","year":"2019","journal-title":"Int J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e113843","DOI":"10.1371\/journal.pone.0113843","article-title":"A multi-center, cross-sectional study on the burden of infectious keratitis in China","volume":"9","author":"Song","year":"2014","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"938","DOI":"10.3760\/cma.j.issn.0412-4081.2010.10.014","article-title":"The current situation and development of anti-blindness and ophthalmic epidemiological research in China","volume":"46","author":"Guan","year":"2010","journal-title":"Chin J Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3390\/clinpract13010024","article-title":"An overview of corneal transplantation in the past decade","volume":"13","author":"Musa","year":"2023","journal-title":"Clin Pract"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"641645","DOI":"10.3760\/cma.j.issn.0412-4081.2014.09.001","article-title":"Academic development direction in the field of corneal diseases in China","volume":"50","author":"Shi","year":"2014","journal-title":"Chin J Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1001\/jamaophthalmol.2015.4776","article-title":"Global survey of corneal transplantation and eye banking","volume":"134","author":"Gain","year":"2016","journal-title":"JAMA Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"20417314221138188","DOI":"10.1177\/20417314221138188","article-title":"A global bibliometric and visualized analysis in the status and trends of corneal tissue engineering research from 1991 to 2021","volume":"13","author":"Niu","year":"2022","journal-title":"J Tissue Eng"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e125","DOI":"10.1111\/j.1755-3768.2011.02261.x","article-title":"Decellularization of porcine corneas and repopulation with human corneal cells for tissue-engineered xenografts","volume":"90","author":"Yoeruek","year":"2012","journal-title":"Acta Ophthalmol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1076\/ceyr.26.5.313.15440","article-title":"Antigenicity of porcine cornea as xenograft","volume":"26","author":"Amano","year":"2003","journal-title":"Curr Eye Res"},{"key":"ref10","first-page":"535","article-title":"Relative quantitative analysis of corneal immunogenicity","volume":"38","author":"Wang","year":"2002","journal-title":"Zhonghua Yan Ke Za Zhi"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1097\/ICO.0000000000001319","article-title":"Preparation and biomechanical properties of an acellular porcine corneal stroma","volume":"36","author":"Li","year":"2017","journal-title":"Cornea"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1097\/ICO.0000000000002772","article-title":"Ten-year follow-up of lamellar Keratoplasty treatment with acellular porcine corneal stroma: a case report","volume":"41","author":"Xiao","year":"2022","journal-title":"Cornea"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1111\/ajt.13096","article-title":"Lamellar keratoplasty treatment of fungal corneal ulcers with acellular porcine corneal stroma","volume":"15","author":"Zhang","year":"2015","journal-title":"Am J Transplant"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"7257","DOI":"10.1016\/j.biomaterials.2010.05.066","article-title":"A rabbit anterior cornea replacement derived from acellular porcine cornea matrix, epithelial cells and keratocytes","volume":"31","author":"Pang","year":"2010","journal-title":"Biomaterials"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1111\/vop.12884","article-title":"Penetrating Keratoplasty in dogs using acellular porcine corneal stroma (BioCorneaVet\u2122): a prospective pilot study of five cases","volume":"24","author":"Lavaud","year":"2021","journal-title":"Vet Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e12566","DOI":"10.1111\/xen.12566","article-title":"Healing characteristics of acellular porcine corneal stroma following therapeutic keratoplasty","volume":"27","author":"Li","year":"2020","journal-title":"Xenotransplantation"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3760\/cma.j.issn.0412-4081.2016.03.001","article-title":"Focus on the clinical application of China\u2019s first bioengineered cornea","volume":"52","author":"Shi","year":"2016","journal-title":"Chin J Ophthalmol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/s00441-007-0419-1","article-title":"Survival and integration of tissue-engineered corneal stroma in a model of corneal ulcer","volume":"329","author":"Zhang","year":"2007","journal-title":"Cell Tissue Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"623","DOI":"10.2147\/TCRM.S309742","article-title":"Efficacy of lamellar Keratoplasty with acellular porcine corneal stroma in treatment for infectious central and peripheral corneal ulcers","volume":"17","author":"Chen","year":"2021","journal-title":"Ther Clin Risk Manag"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1097\/00003226-199109000-00003","article-title":"Clinical and immunohistologic studies of corneal rejection in the rat penetrating keratoplasty model","volume":"10","author":"Holland","year":"1991","journal-title":"Cornea"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"727","DOI":"10.3760\/cma.j.cn112142-20210713-00333","article-title":"Chinese expert consensus on keratoprosthesis procedure (2021)","volume":"57","year":"2021","journal-title":"Zhonghua Yan Ke Za Zhi"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1007\/s00417-012-1947-2","article-title":"Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis","volume":"250","author":"Wang","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e12655","DOI":"10.1111\/xen.12655","article-title":"Deep anterior lamellar keratoplasty with cross-linked acellular porcine corneal stroma to manage fungal keratitis","volume":"28","author":"Zheng","year":"2021","journal-title":"Xenotransplantation"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"100876","DOI":"10.1016\/j.preteyeres.2020.100876","article-title":"Corneal xenotransplantation: where are we standing?","volume":"80","author":"Yoon","year":"2021","journal-title":"Prog Retin Eye Res"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1364\/josa.66.000342","article-title":"On corneal transparency and its loss with swelling","volume":"66","author":"Farrell","year":"1976","journal-title":"J Opt Soc Am"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.actbio.2018.01.023","article-title":"Corneal regeneration: a review of stromal replacements","volume":"69","author":"Matthyssen","year":"2018","journal-title":"Acta Biomater"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"101090","DOI":"10.1016\/j.preteyeres.2022.101090","article-title":"Corneal stromal repair and regeneration","volume":"91","author":"Mohan","year":"2022","journal-title":"Prog Retin Eye Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"4044","DOI":"10.1167\/iovs.18-24428","article-title":"The corneal basement membranes and stromal fibrosis","volume":"59","author":"Medeiros","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.preteyeres.2017.04.002","article-title":"Alternatives to eye bank native tissue for corneal stromal replacement","volume":"59","author":"Brunette","year":"2017","journal-title":"Prog Retin Eye Res"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1016\/j.survophthal.2023.06.007","article-title":"The role of matrix metalloproteinases in infectious corneal ulcers","volume":"68","author":"Garc\u00eda-L\u00f3pez","year":"2023","journal-title":"Surv Ophthalmol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"CD007824","DOI":"10.1002\/14651858.CD007824","article-title":"Oral antivirals for preventing recurrent herpes simplex keratitis in people with corneal grafts","volume":"11","author":"Bhatt","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e12509","DOI":"10.1111\/xen.12509","article-title":"Short-term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis","volume":"26","author":"Zheng","year":"2019","journal-title":"Xenotransplantation"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1534210\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:19:57Z","timestamp":1742195997000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1534210\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":32,"alternative-id":["10.3389\/fmed.2025.1534210"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1534210","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"article-number":"1534210"}}