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Biocompatible oligochitosans as cationic modifiers of alginate/Ca microcapsules
Orive, G., A. Bartkowiak, et al. (2005), J Biomed Mater Res B Appl Biomater 74(1): 429-39.
Abstract: In the past, it has been proven that by properly adjusting the molecular mass of the oligochitosan samples, it is possible to optimize the formation of rigid, biocompatible capsules with semipermeable membranes under physiological conditions. In this study, the feasibility of four oligochitosan samples, with varying molar masses (M(n) in range 3-5 kDa), as biocompatible coatings of alginate/Ca capsules was investigated. By selection of appropriate depolymerization and purification methods we obtained oligochitosan samples that appeared to be noncytotoxic for C(2)C(12) myoblasts and did not influence the mammalian cell metabolism especially in relative short time during the process of capsule formation. Furthermore, oligochitosans can be used as a tool to reduce the membrane cut-off of the alginate capsules. However, such reduction, as well as mechanical resistance of formed microcapsules, depend on MM of the cationic polysaccharide and the chemical composition of the alginate (mannuronic/guluronic acid ratio). Here, we address that the use of low molar mass chitosan (< 5000 g/mol) permits the formation of mechanical stable capsules at physiological pH, which represents a strong advantage over other chitosan-based chemistries.

Biodegradable dextran-based microspheres for delivery of anticancer drug mitomycin C
Cheung, R. Y., Y. Ying, et al. (2005), Biomaterials 26(26): 5375-85.
Abstract: The purpose of this work was to develop a biodegradable microsphere (MS) system for delivering mitomycin C (MMC). Various dextran-based MS systems were investigated for their loading and release characteristics, including nonionic MS, sulfopropyl dextran microspheres (SP-MS) with low or high cross-linking density, oxidized SP-MS (Ox-MS), and hydrophobically modified SP-MS. SP-MS were chemically modified by oxidation with sodium periodate or by reaction with anhydride. The chemical structure of modified SP-MS and MMC-loaded MS (MMC-MS) were examined using Fourier transform infrared (FTIR) and solid-state nuclear magnetic resonance (NMR) spectrophotometry. Drug release was conducted at 37 degrees C in aqueous solutions of 0.15 m phosphate buffer solution. The kinetics of drug absorption and release and the stability of MMC after loading and release were determined by spectrophotometry and high-performance liquid chromatography. Ionic SP-MS exhibited a higher drug-loading rate and capacity when compared to nonionic MS, while hydrophobically modified SP-MS showed an even greater loading capacity than SP-MS. These results suggest that both ionic complexation and hydrophobic interaction were important factors in MMC loading. The Ox-MS system demonstrated higher drug-loading capacity, more fractional drug release and a longer time to reach release equilibrium as compared to other investigated MS systems. Under optimized reaction and loading conditions, MMC released from Ox-MS was found to be unaltered. This work demonstrates that the Ox-MS system is a potentially useful system for the delivery of MMC.

Biodegradable elastomeric biomaterials--polyethylene oxide/polyethylene terephthalate copolymers
Reed, A. M., D. K. Gilding, et al. (1977), Trans Am Soc Artif Intern Organs 23: 109-15.

Biodegradable open cell foams of telechelic poly(epsilon-caprolactone) macroligand with ruthenium (II) chromophoric subunits via sub-critical CO2 processing
Nawaby, A. V., A. A. Farah, et al. (2005), Biomacromolecules 6(5): 2458-61.
Abstract: This work reports on the effect of CO2 at subcritical conditions and the gaseous state on the telechelic poly(epsilon-caprolactone) polymers. The tested polymers are semi-crystalline in nature and thus the effect of functional groups and their overall contribution to foaming and formation of microstructures with open-cell morphollogy is discussed.

Biodegradable poly(D,L-lactic acid)-poly(ethylene glycol)-monomethyl ether diblock copolymers: structures and surface properties relevant to their use as biomaterials
Lucke, A., J. Tessmar, et al. (2000), Biomaterials 21(23): 2361-70.
Abstract: To obtain biodegradable polymers with variable surface properties for tissue culture applications, poly(ethylene glycol) blocks were attached to poly(lactic acid) blocks in a variety of combinations. The resulting poly(D,L-lactic acid)-poly(ethylene glycol)-monomethyl ether (Me.PEG-PLA) diblock copolymers were subject to comprehensive investigations concerning their bulk microstructure and surface properties to evaluate their suitability for drug delivery applications as well as for the manufacture of scaffolds in tissue engineering. Results obtained from 1H-NMR, gel permeation chromatography, wide angle X-ray diffraction and modulated differential scanning calorimetry revealed that the polymer bulk microstructure contains poly(ethylene glycol)-monomethyl ether (Me.PEG) domains segregated from poly(D,L-lactic acid) (PLA) domains varying with the composition of the diblock copolymers. Analysis of the surface of polymer films with atomic force microscopy and X-ray photoelectron spectroscopy indicated that there is a variable amount of Me.PEG chains present on the polymer surface, depending on the polymer composition. It could be shown that the presence of Me.PEG chains in the polymer surface had a suppressive effect on the adsorption of two model peptides (salmon calcitonin and human atrial natriuretic peptide). The possibility to modify polymer bulk microstructure as well as surface properties by variation of the copolymer composition is a prerequisite for their efficient use in the fields of drug delivery and tissue engineering.

Biodegradable poly(terephthalate-co-phosphate)s: synthesis, characterization and drug-release properties
Mao, H. Q., I. Shipanova-Kadiyala, et al. (2005), J Biomater Sci Polym Ed 16(2): 135-61.
Abstract: To develop biodegradable polymers with favorable physicochemical and biological properties, we have synthesized a series of poly(terephthalate-co-phosphate)s using a two-step poly-condensation. The diol 1,4-bis(2-hydroxyethyl) terephthalate was first reacted with ethylphosphorodichloridate (EOP), and then chain-extended with terephthaloyl chloride (TC). Incorporation of phosphate into the poly(ethylene terephthalate) backbone rendered the co-polymers soluble in chloroform and biodegradable, lowered the Tg, decreased the crystallinity and increased the hydrophilicity. With an EOP/TC molar feed ratio of 80: 20, the polymer exhibited good film-forming property, yielding at 86.6 +/- 1.6% elongation with an elastic modulus of 13.76 +/- 2.66 MPa. This polymer showed a favorable toxicity profile in vitro and good tissue biocompatibility in the muscular tissue of mice. In vitro the polymer lost 21% of mass in 21 days, but only 20% for up to 4 months in vivo. It showed no deterioration of properties after sterilization by gamma-irradiation at 2.5 Mrad on solid CO2. Release of FITC-BSA from the microspheres was diffusion-controlled and exceeded 80% completion in two days. Release of the hydrophobic cyclosporine-A from microspheres was however much more sustained and near zero-ordered, discharging 60% in 70 days. A limited structure-property relationship has been established for this co-polymer series. The co-polymers became more hydrolytically labile as the phosphate component (EOP) was increased and the side chains were switched from the ethoxy to the methoxy structure. Converting the methoxy group to a sodium salt further increased the degradation rate significantly. The chain rigidity as reflected in the Tg values of the co-polymers decreased according to the following diol structure in the backbone: ethylene glycol > 2-methylpropylene diol > 2,2-dimethylpropylene diol. The wide range of physicochemical properties obtainable from this co-polymer series should help the design of degradable biomaterials for specific biomedical applications.

Biodegradable polydioxanone and poly(l/d)lactide implants: an experimental study on peri-implant tissue response
Kontio, R., P. Ruuttila, et al. (2005), Int J Oral Maxillofac Surg 34(7): 766-76.
Abstract: Several implants for orbital wall fracture treatment are available at the present, but they have drawbacks: resorption, risk for migration and foreign body reaction. Alloplastic resorbable implants would be advantageous: no removal operation and no donor side morbidity. The purpose of this study was to evaluate the foreign body reaction, capsule formation and mechanical properties of two bioresorbable implants. PDS and SR-P(L/DL)LA mesh sheet (70/30) with solid frame (96/4) implants (SR-P(L/DL)LA 70,96) were placed into subcutaneous tissue of 24 rats. Immunohistochemistry was used to evaluate reactivity for Tn-C, alpha-actin, type I and III collagens and two mononuclear cells: T-cells and monocyte/ macrophage. GPC, DSC and SEM were performed. Student's t-test or nonparametric Kruskall-Wallis test were used for statistical analysis. Histology of peri-implant capsule exhibited an inner cell-rich zone and an outer connective tissue zone around both materials. Tn-C reactivity was high in the inner and alpha-actin in the outer zone. At the end of the study, the difference of type I collagen versus type III collagen reactivity in inner zone was statistically significant (P<0.0001) as was the difference of type I collagen versus type III collagen reactivity in outer zone (P<0.0001). Immunohistochemistry did not reveal any statistical differences of T-cell and monocyte/macrophage reactivity around PDS versus SR-P(L/DL)LA 70,96 implants, nor any differences as a function of time. PDS were deformed totally after 2 months. SR-P(L/DL)LA 70,96 implants were only slightly deformed during the follow up of 7 months. PDS degraded rapidly in SEM observation. Particles were detaching from surface. SEM observation revealed that polylactide implant was degrading from the surface and the inner porous core became visible. The degradation came visible at 7 months. There were cracks in perpendicular direction towards to the long axis of the filaments. M(w) of PDS decreased fast compared to the polylactide implant. Foreign body reaction was minimal to both materials but continued throughout the whole observation period. Mechanically PDS was poor, it looses its shape totally within 2 months. It cannot be recommended for orbital wall reconstruction. New mesh sheet-frame structure (SR-P(L/DL)LA 70,96) approved to be mechanically adequate for orbital wall reconstruction. It seems not to possess intrinsic memory and retains its shape. The resorption time is significantly longer compared to PDS and is comparable to other studied P(L/DL)LA copolymers. Thus, the new polylactide copolymer implant may support the orbital contents long enough to give way to bone growth over the wall defect.

Biodegradable polymer microneedles: fabrication, mechanics and transdermal drug delivery
Park, J. H., M. G. Allen, et al. (2005), J Control Release 104(1): 51-66.
Abstract: To overcome the skin's barrier properties that block transdermal delivery of most drugs, arrays of microscopic needles have been microfabricated primarily out of silicon or metal. This study addresses microneedles made of biocompatible and biodegradable polymers, which are expected to improve safety and manufacturability. To make biodegradable polymer microneedles with sharp tips, micro-electromechanical masking and etching were adapted to produce beveled- and chisel-tip microneedles and a new fabrication method was developed to produce tapered-cone microneedles using an in situ lens-based lithographic approach. To replicate microfabricated master structures, PDMS micromolds were generated and a novel vacuum-based method was developed to fill the molds with polylactic acid, polyglycolic acid, and their co-polymers. Mechanical testing of the resulting needles measured the force at which needles broke during axial loading and found that this failure force increased with Young's modulus of the material and needle base diameter and decreased with needle length. Failure forces were generally much larger than the forces needed to insert microneedles into skin, indicating that biodegradable polymers can have satisfactory mechanical properties for microneedles. Finally, arrays of polymer microneedles were shown to increase permeability of human cadaver skin to a low-molecular weight tracer, calcein, and a macromolecular protein, bovine serum albumin, by up to three orders of magnitude. Altogether, these results indicate that biodegradable polymer microneedles can be fabricated with an appropriate geometry and sufficient strength to insert into skin, and thereby dramatically increase transdermal transport of molecules.

Biodegradable polymers as biomaterials
Piskin, E. (1995), J Biomater Sci Polym Ed 6(9): 775-95.
Abstract: Biomaterials are used in prostheses and medical devices for different purposes. Polymers are the most diverse class of biomaterials. All biomaterials must meet certain criteria and regulatory requirements before they can be qualified for use in medical applications. Biocompatibility is one of the most important requirements. Both nondegradable polymers are designed to degrade in vivo in a controlled manner over a predetermined time. The main mechanism of in vivo degradation of polymers is 'hydrolytic degradation', in which enzymes may also play a role (i.e. 'enzymatic degradation'). Both natural e.g., collagen, and synthetic e.g., poly(alpha-hydroxy) acids, biodegradable polymers are used in biomedical applications. Many of the current polymers and processing techniques need to be improved in order to produce polymers with better performance in biological media. An important trend in related research and development is the synthesis of novel polymers, which would exhibit improved biocompatibility, and be bioresponsive.

Biodegradable positively charged ion exchange beads: a novel biomaterial for enhancing soft tissue repair
Christoforou, C., X. Lin, et al. (1998), J Biomed Mater Res 42(3): 376-86.
Abstract: Previous work in the area of vulnerary agents is extensive. One material of focus has been positively charged ion exchange beads, which have been shown to promote a variety of wound-healing responses in several models. The goal of this work was to improve upon the clinical utility of positively charged dextran beads by creating a biodegradable version that maintains the material's inherent efficacy. A chemical method consisting of a sodium periodate oxidation was used to create a degradable diethylaminoethanol crosslinked dextran bead. The ability of this process to create a degradable bead was verified in vitro and in vivo. Furthermore, efficacy was shown in a rat linear incision model for a variety of beads exhibiting different degradation rates. The results show that efficacy is maintained by a degradable bead, but there is a diminution of the magnitude of the response as the mass loss rate is increased. Efficacy also was investigated for a moderate but completely degrading bead material over time and dose. Wound breaking strength was evaluated at days 7, 10, 14, 21, and 28 for degradable beads at doses of 10 mg/mL and 50 mg/mL. Although little difference in efficacy was noted for the increased dose, statistically significant increases over control were seen at days 7, 10, and 14 for the 10 mg/mL dose and at days 10 and 14 for the 50 mg/mL dose. At days 21 and 28 there were no differences between treated and control wounds.

Biodegradation of differently cross-linked collagen membranes: an experimental study in the rat
Rothamel, D., F. Schwarz, et al. (2005), Clin Oral Implants Res 16(3): 369-78.
Abstract: The aim of the present study was to compare the biodegradation of differently cross-linked collagen membranes in rats. Five commercially available and three experimental membranes (VN) were included: (1) BioGide (BG) (non-cross-linked porcine type I and III collagens), (2) BioMend (BM), (3) BioMendExtend (BME) (glutaraldehyde cross-linked bovine type I collagen), (4) Ossix (OS) (enzymatic-cross-linked bovine type I collagen), (5) TutoDent (TD) (non-cross-linked bovine type I collagen, and (6-8) VN(1-3) (chemical cross-linked porcine type I and III collagens). Specimens were randomly allocated in unconnected subcutaneous pouches separated surgically on the back of 40 wistar rats, which were divided into five groups (2, 4, 8, 16, and 24 weeks), including eight animals each. After 2, 4, 8, 16, and 24 weeks of healing, the rats were sacrificed and explanted specimens were prepared for histologic and histometric analysis. The following parameters were evaluated: biodegradation over time, vascularization, tissue integration, and foreign body reaction. Highest vascularization and tissue integration was noted for BG followed by BM, BME, and VN(1); TD, VN(2), and VN(3) showed prolongated, while OS exhibited no vascularization. Subsequently, biodegradation of BG, BM, BME and VN(1) was faster than TD, VN(2), and VN(3). OS showed only a minute amount of superficial biodegradation 24 weeks following implantation. Biodegradation of TD, BM, BME, VN(2), and VN(3) was associated with the presence of inflammatory cells. Within the limits of the present study, it was concluded that cross-linking of bovine and porcine-derived collagen types I and III was associated with (i) prolonged biodegradation, (ii) decreased tissue integration and vascularization, and (iii) in case of TD, BM, BME, VN(2), and VN(3) foreign body reactions.

Biodendrimers: new polymeric biomaterials for tissue engineering
Grinstaff, M. W. (2002), Chemistry 8(13): 2839-46.
Abstract: Dendrimers composed entirely of building blocks known to be biocompatible or degradable in vivo to natural metabolites were synthesized using a high yield divergent approach. This synthesis is amenable to the design and development of new biomaterials that are of interest for a variety of medical applications, including tissue engineering. In a novel application, photocross-linkable dendrimers are used to seal large corneal lacerations.

Biodesulfurization of dibenzothiophene by microbial cells coated with magnetite nanoparticles
Shan, G., J. Xing, et al. (2005), Appl Environ Microbiol 71(8): 4497-502.
Abstract: Microbial cells of Pseudomonas delafieldii were coated with magnetic Fe3O4 nanoparticles and then immobilized by external application of a magnetic field. Magnetic Fe3O4 nanoparticles were synthesized by a coprecipitation method followed by modification with ammonium oleate. The surface-modified Fe3O4 nanoparticles were monodispersed in an aqueous solution and did not precipitate in over 18 months. Using transmission electron microscopy (TEM), the average size of the magnetic particles was found to be in the range from 10 to 15 nm. TEM cross section analysis of the cells showed further that the Fe3O4 nanoparticles were for the most part strongly absorbed by the surfaces of the cells and coated the cells. The coated cells had distinct superparamagnetic properties. The magnetization (delta(s)) was 8.39 emu.g(-1). The coated cells not only had the same desulfurizing activity as free cells but could also be reused more than five times. Compared to cells immobilized on Celite, the cells coated with Fe3O4 nanoparticles had greater desulfurizing activity and operational stability.

Biodistribution properties of nanoparticles based on mixtures of PLGA with PLGA-PEG diblock copolymers
Beletsi, A., Z. Panagi, et al. (2005), Int J Pharm 298(1): 233-41.
Abstract: The basic characteristics and the biodistribution properties of nanoparticles prepared from mixtures of poly(lactide-co-glycolide) (PLGA) with poly(lactide-co-glycolide)-poly(ethylene glycol) (PLGA-PEG) copolymers were investigated. A PLGA(45)-PEG(5) copolymer of relatively low PEG content and a PLGA(5)-PEG(5) copolymer of relatively high PEG content were included in the study. Increasing the PLGA-PEG content of the PLGA/PLGA-PEG mixture, or when PLGA(45)-PEG(5) was replaced by PLGA(5)-PEG(5), a decrease in the size of the nanoparticles and an increase in the rate of PEG loss from the nanoparticles were observed. The blood residence of the PLGA/PLGA(45)-PEG(5) nanoparticles increased as their PLGA-PEG content was increased, reaching maximum blood longevity at 100% PLGA(45)-PEG(5). On the contrary, the blood residence of PLGA/PLGA(5)-PEG(5) nanoparticles exhibited a plateau maximum in the range of 80-100% PLGA(5)-PEG(5). At PLGA-PEG proportions lower than 80%, the PLGA/PLGA(45)-PEG(5) nanoparticles exhibited lower blood residence than the PLGA/PLGA(5)-PEG(5) nanoparticles, whereas at PLGA-PEG proportions higher than 80%, the PLGA/PLGA(45)-PEG(5) nanoparticles exhibited higher blood residence than the PLGA/PLGA(5)-PEG(5) nanoparticles. These findings indicate that apart from the surface PEG content, the biodistribution properties of the PLGA/PLGA-PEG nanoparticles are also influenced by the size of the nanoparticles and the rate of PEG loss from the nanoparticles.

Bioengineered tissues: the science, the technology, and the industry
Ahsan, T. and R. M. Nerem (2005), Orthod Craniofac Res 8(3): 134-40.
Abstract: OBJECTIVE: The bioengineering of tissues and organs, sometimes called tissue engineering and at other times regenerative medicine, is emerging as a science, as a technology, and as an industry. The goal is the repair, replacement, and/or the regeneration of tissues and organs. The objective of this paper is to identify and discuss the major issues that have become apparent. RESULTS: One of the critical issues is that of cell source, i.e. what will be the source of the cells to be employed? Another critical issue is the development of approaches for the fabrication of substitute tissues/organs and/or vehicles for the delivery of biological active molecules for use in the repair/regeneration of tissues. A third critical issue, one very much related to cell source, is that of immune acceptance. In addition, there are technological hurdles; there are additional issues such as the scale-up of manufacturing processes and the preservation of living-cell products for off-the-shelf availability. Although the initial products have been superficially applied skin substitutes, as this fledgling industry continues to evolve, it is beginning to focus on a wider range of more invasive and complicated products. From a public health perspective, the real opportunity may be in addressing chronic diseases, as well as the transplantation crisis (i.e. the tremendous disparity between patient need for vital organs and donor availability) and, equally important is the challenge of neural repair. CONCLUSION: These are the grand challenges, and the scientific community, business/private sector, and federal government must mobilize itself together in this emerging area to translate the benchtop science to the patient bedside.

Bioethics and applied biomaterials
Saha, S. and P. Saha (1987), J Biomed Mater Res 21(Suppl. A2): 181-90.

Bioincompatible biomaterials for extracorporeal immunomodulation
Nose, Y. (1988), Artif Organs 12(5): 377-8.

Biological activities of sustained polymyxin B release from calcium phosphate biomaterial prepared by dynamic compaction: an in vitro study
Kimakhe, S., S. Bohic, et al. (1999), J Biomed Mater Res 47(1): 18-27.
Abstract: Calcium phosphate ceramics (CaP) have recently been proposed as a potential matrix for a bioactive drug delivery system (DDS) in which the effect in situ of a released therapeutic agent is favored by the biocompatibility, osteoconductivity, and bioresorption of the ceramic material. Polymyxin B (PMB) is a polypeptidic antibiotic which undergoes thermodamage above 60 degrees C. The dynamic compaction method was developed to consolidate the drug load on CaP powder without external heating. Two projectile velocities (50 and 25 m/s) were used here to achieve powder consolidation. Among the different techniques used to associate therapeutic agents with CaP, wet adsorption was performed before the dynamic compaction process. The PMB release profile was measured by a capillary electrophoresis technique, CaP crystallography was studied by x-ray diffraction, and CaP physicochemical analysis was performed by infrared spectroscopy. The biological activities of PMB-loaded compacted CaP were determined by the effect of the antibiotic and monocyte/macrophage degradation on compact surfaces. PMB release began after 2-3 days of incubation for blocks compacted at 25 m/s velocity and on day 5 for those compacted at 50 m/s velocity. A discrepancy was noted between the amounts of PMB released (0.5-2.1 mg) and the amounts initially compacted (2-8 mg) with CaP powder. The biological activities (antibacterial activity and inhibited lipopolysaccharide effects on monocyte/macrophage CaP degradation) of PMB released from compacted calcium-deficient apatite were unaltered. Thus, dynamic compaction allows PMB to be used with CaP ceramics without any loss in its integrity and biological effects.

Biological assembly of nanocircuit prototypes from protein-modified CdTe nanowires
Wang, Y., Z. Tang, et al. (2005), Nano Lett 5(2): 243-8.
Abstract: CdTe nanowires made by self-organization of CdTe nanoparticles in aqueous media were separately conjugated with complementary biological connectors, such as antigen-antibody and biotin-streptavidin. Transmission electron microscopy images and Forster resonance energy transfer measurements in nanowire superstructures with different diameters indicate that biological affinity of the attached proteins results in the formation of crossbar and end-to-side connections between the nanowires. A prototype of a logical circuit made from a triangular arrangement of the nanowires spontaneously assembled on a Si substrate was examined by conducting atomic force microscopy. While diode-like behavior was observed in the sides of the triangle, the nanowire junction points were found to be nonconductive. It was attributed to high tunneling barrier created by protein molecules wedged between the nanowires. Suggestions are made how to reduce it or use the insulating gap between the nanowires as a framework for single-electron devices.

Biological compatibility of polymethyl methacrylate, hydrophilic acrylic and hydrophobic acrylic intraocular lenses
Barbour, W., S. Saika, et al. (2005), Ophthalmic Res 37(5): 255-61.
Abstract: PURPOSE: Extensive clinical investigations of the biocompatibility of different intraocular lenses (IOLs) have been made in an effort to optimize the outcome of modern cataract surgery. The aim of this study was to add animal eye experimental implantation data regarding cellular reaction on the anterior surface of IOLs. METHODS: Thirteen adult albino rabbits had phacoemulsification/aspiration of the crystalline lens followed by implantation of a posterior chamber IOL in each eye. Three types of IOLs were studied: Hydroview (Bausch and Lomb; n = 7), Acrysof (Alcon, USA; n = 7), and polymethyl methacrylate (PMMA; HOYA, Japan; n = 7). The animals were killed by intravenous pentobarbital 1, 4, or 8 weeks later. The IOLs were explanted and stained with hematoxylin and eosin, and observed under a light microscope. The shape of mouse ascites-induced macrophages on the anterior surface of the three different IOL types (Hydroview, PMMA, and Acrysof) was studied after 24 h of oven culture. RESULTS: Hydrophilic acrylic IOLs showed the highest affinity for lens epithelial cell (LEC) outgrowth, and the lowest and slowest maturation rate reaction of macrophages. PMMA IOLs showed the lowest affinity for LEC outgrowth, and the highest reaction of macrophages. Hydrophobic acrylic IOLs showed intermediate results both regarding LECs and macrophages. CONCLUSIONS: Results suggest that IOL biomaterial properties are the key factor that influences the quantity of monocytes/macrophages as well as the process of their maturation/senescence. LEC outgrowth is influenced both by the biomaterial of IOLs and by the monocyte/macrophage reaction.


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