1. Introduction
Eye evisceration (partial removal of the eyeball) is one of the methods used to eradicate the eyeball defects and the infection for patients with serious oculoorbital injuries, intraocular cancers, and other life-threatening diseases [
1,
2,
3].The formation of a full-fledged musculoskeletal stump of the eyeball after its removal is a necessary condition for achieving a satisfactory functional and aesthetic effect of subsequent ocular prosthetics and, consequently, effective medical and social rehabilitation of the patient [
4,
5,
6,
7,
8,
9,
10,
11].
Currently, biological (fat, cartilage, bone, etc.), natural (hydroxyapatite), and synthetic (polymeric, ceramic, metallic, carbon, etc.) orbital implants are used to form the musculoskeletal stump of the eyeball. Certainly, all of them have a number of disadvantages. Biological implants are subject to gradual resorption, and they do not ensure the constancy of the volume and shape of the eyeball stump [
12,
13,
14], or normal growth of orbital bones in children [
15]. Also, the need for bacterial and virological testing of donor material requires compliance with the rules of its conservation and storage, the creation of a network of tissue banks, which significantly increases the cost of treatment. The disadvantages of natural and some synthetic orbital implants (polymeric, ceramic, carbon based, etc.) are their exposure, rejection and deformation [
13,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25]. Metallic implants were found to be well-applicable and very promising for use in ophthalmology in general, and for the formation of the full-fledged musculoskeletal stump of the eyeball after its removal, in particular [
25].
The use of TiNi implants in ophthalmology was previously described elsewhere [
26]. The authors studied in detail TiNi implants for the formation of the musculoskeletal stump of the eyeball in the form of monolithic thread, porous-permeable alloy, fabric, mesh, and fiber. In general, porous surface is considered preferable, even in monolithic implantable structures [
1]. Porous alloys based on TiNi are quite widely used as materials for implants. The combination of both high biomechanical and biochemical compatibility of TiNi-based porous materials with body tissues makes it possible to solve highly complex problems in various fields of medicine [
1,
27,
28,
29,
30,
31,
32,
33,
34]. Biocompatible porous TiNi materials for medical use are typically produced by the self-propagating high-temperature synthesis (SHS) and sintering [
33,
34,
35,
36]. These methods permit to obtain porous materials with martensitic transformations in a wide temperature range, also with a developed structure of the pore volume, an optimal porosity of 50–70%, and an average pore size of 90–150 μm [
25].
Unlike sintering, the SHS method is characterized by the highest energy efficiency. TiNi powders are used during sintering. On the contrary, Ti and Ni powders are used during SHS. The implementation of an exothermic chemical reaction in an argon environment leads to the production of a porous material with a high degree of phase-chemical heterogeneity. Large-sized biocompatible porous materials with a highly porous, permeable three-dimensional macrostructure can be created due to the formation of numerous interconnected pores during layer-by-layer synthesis of the alloy.
It is well-known that the surface of the pore walls of porous TiNi-based alloys obtained by the SHS has a high concentration of Ti
2Ni and Ti
4Ni
2(O,N,C) second-phase particles. Their formation is associated with the high activity of Ti at high temperatures and its segregation on the surface of pore walls [
37,
38,
39,
40]. Unfortunately, such particles can reduce the mechanical properties of the material, since they are brittle and serve as sites for crack propagation during destruction. Also, these particles are the centers where corrosion begins, thereby their presence reduces corrosion resistance of the material. In the present work, however, we take advantage of their availability to further improve the material surface.
The process of interaction of body tissues with an implanted device is known to be determined by the morphochemical parameters of the surface of the pore walls [
41,
42]. When operating inside the body, the pore space of porous implant is filled with living tissues and tissue fluids. It has been experimentally established that the pore size, pore size distribution and morphology of the surface of pore walls have a great effect on the cell culture integration in the pore space of implant material [
43,
44,
45]. Thus, materials possessing pore walls with microporous structures are more preferable for attachment of cellular cultures. It has increased specific surface area and individual micropores can serve as a nutrient depot [
46].
There are certain approaches that can be used to enhance the biocompatibility of the surfaces. For instance, such methods as ion beam and plasma treatment, laser-based surface processing, ion and electronic alloying with Si, Mo, Ta were previously employed to improve the surface of monolithic alloys by applying various protective coatings [
47,
48,
49,
50,
51,
52]. Another approach is based on preparing biodegradable hydroxyapatite films or on adding this compound to powders when a porous material is prepared [
53]. However, the use of the above-mentioned modification methods is impossible in the case of porous-permeable materials as some technical limitations can emerge. More specifically, there are difficulties with delivering the modifier substance into the pore volume. Moreover, to accelerate the processes of integration of TiNi-based material with cells, it is necessary not to create protective coatings, but to improve the structure of the pore walls surface and of the macropores volume [
25].
In the case of SHS-produced materials, structural improvements are possible due to the presence of open, interconnected pores and the possibility to access into the pore space [
27]. Such porous structures could be created using different approaches. For instance, in some works [
54,
55] a powder of NaCl was used for construction of interconnected pore system with a certain size of pore channels. Highly porous materials (up to 90%) with macropores can be obtained depending on the granulometric composition of NaCl powder. Another approach used for the creation of special porous space with certain design is application of ultrasonication during SHS process [
56]. This was found to reduce the number of cavities and increase the maximum pre-heating temperature without their formation. Additive technologies for manufacturing of porous materials with complex structure of pore channels were also described elsewhere [
57,
58]. Such works typically aimed at modifying the macrostructure of the pore space, while the microstructure remained unchanged, thus leading to pronounced phase-chemical heterogeneity.
Here, we propose to form microporous surface on pore walls of porous-permeable TiNi produced via SHS by etching away the above-mentioned second-phase particles inside the pores. This way, the formation of such particles during SHS can be turned from material’s weakness to its advantage, if the newly formed structure shows enhanced biocompatibility and bio-integration. So, the creating a larger specific surface area via modification of the material would help increase its adhesive properties for tissue cells. In light of this, the most acceptable etching technique would be applying an aqueous solution of nitric and hydrofluoric acids, which potentially can lead to the formation of a microporous surface on pore walls with micro-sized pores corresponding to the size of etched Ti2Ni and Ti4Ni2(O,C) particles.
Thus, the main goal of this study was to develop a method for modifying the pore space of SHS-generated TiNi material by creating a rough surface on its pore walls. After such a modification, the material should become more suitable for the attachment and development of cell cultures inside its pores. We also aimed to study integration processes in the implant-tissue system using the modifided TiNi. The use of this material for implanting will ensure formation of a reliable connection between the implant and the surrounding biological tissues of the eye. To achieve the above-mentioned goals, the present work focused on studying the process of formation of microporous surface of pore walls by etching of Ti2Ni and Ti4Ni2(O,C) particles with sizes of 0.1–5 μm. Therefore, the novelty of this work lies on the simple and effective surface modification approach that permits to enhance the biocompatibility and bio-integration of SHS-produced porous TiNi material. Thus-modified porous TiNi was demonstrated to show promise for its use as ophthalmology implants in the future.
2. Materials and Methods
2.1. Material Preparation
In this work, porous alloys based on TiNi were obtained by the SHS method using titanium and nickel powders. The initial Ti (PTOM, purity of 99.94%), Ni (PNK, purity of 99.90%) powders were dried in a GP-20 dry-heat oven (SKTB SPU, Smolensk, Russia) at a temperature of 85-95 °C for 7 h. Then they were mixed in an equiatomic ratio in a mixer С2К/6 (Techno center, Rybinsk, Russia) for 8 h. The resulting mixture was poured into a quartz flask, compacted for 30 min to a green porosity of 75-80%, and placed in a metal reactor. SHS was carried out in an electric tubular furnace SUOL (Tula-Term, Tula, Russia) in an Ar gas atmosphere (Khimmedsnab, Tomsk, Russia). When the temperature reached 450°C, SHS was initiated by short-circuiting an electrical circuit with a voltage of 220 V at the open end of the Ti-Ni blank. For further studies and use, samples of 4 mm × 4 mm × 35 mm in size were cut from the obtained blanks using an ARTA 123 PRO electrical discharge machine (NPK "Delta-Test", Fryazino, Russia).
2.2. Modification of the Material
The resulting porous material was treated by chemical etching with solutions of nitric and hydrofluoric acids diluted with distilled water in a ratio of 1:1:3. Both acids, nitric (65%) and hydrofluoric (45%), were chemically pure and were purchased from Sigmatek (Khimki, Russia). The etching time was 7–10 s at a temperature of 20°C. The etching process occurred in several stages. The experimental sample was immersed in the solution for 2–3 s, taken out for 5 s and immersed again until the time spent in the solution reached 7–10 s. This was done because the treatment was accompanied by abundant gas evolution and there might be a difference in the degree of etching in the center and at the periphery of the sample.
The immersion time was selected experimentally. The etching stages were studied by observing the structural features of experimental samples after etching. The first stage took about 2–3 s, and then the second and third and fourth ones took 3–7, 7–10, and more than 10 s, respectively. After etching, the samples were thoroughly rinsed and immersed in water for 12 h.
2.3. Sample Characterization
Metallographic studies were carried out using an Axiovert-40MAT optical microscope (Carl Zeiss, Oberkochen, Germany). The features of the microstructure and chemical composition of the alloys were studied on a scanning electron microscope SEM 515 (Philips, Amsterdam, the Netherlands) with an EDAX ECON IV microanalyzer (EDAX, Mahwah, NJ, USA). The phase composition was studied using X-ray diffraction analysis on a Shimadzu XRD 6000 diffractometer (Shimadzu, Kyoto, Japan). The size of pores and interpore bridges was determined by a combination of the secant method and the inscribed sphere method. Based on the obtained data, size distribution histograms of pores and interpore bridges were constructed. Porosity was determined by weighing using a GH-200 balance (A&D, Tokyo, Japan). Permeability was determined using the Darcy formula [
25]:
where
Q is the fluid flow rate proportional to the density of the fluid (
ρ) and inversely proportional to its viscosity (
µ);
L is the length of the sample; ∆
H is the fluid level;
g is the gravitational acceleration;
S0 is the cross-sectional area of the sample; and
П is porosity. The permeability coefficient was calculated in three perpendicular directions.
2.4. Cell Development Processes
All procedures involving animals were carefully carried out following strictly the Declaration of Helsinki of 1975, and in accordance with the European Community’s Council Directive 86/609/EEC. The study protocol was officially approved (approval code number 20/1116/2017 of May 5, 2017) by the Bioethical Committee of Tomsk State University. Bone marrow stem cells of F1 CBA/j hybrid mice were used as cellular material. The femur was removed under sterile conditions, after which the bone marrow was washed out with a syringe into vials.
Before seeding the cells, they were sterilized at 180°C for 60 min. Cultivation was performed in the following medium: DMEM-F12 medium (PanEco, Moscow, Russia), 10% fetal calf serum (HyClone, USA), gentamicin 40 μg/ml (PanEco, Moscow, Russia), and glutamine 250 mg/l (PanEco, Moscow, Russia). Differentiation additives (beta-glycerophosphate 3 mg/ml (Sigma-Aldrich, St. Louis, USA) in a combination with 0.15 mg/ml ascorbic acid (Sigma-Aldrich, St. Louis, USA) were used in the system with osteogenic differentiation.
The cell concentration was adjusted to 107 cells/ml of final medium. The cells were inoculated on TiNi incubators and placed in 50 ml plastic bottles from Corning, Arizona, USA. Incubators with cells were kept at a temperature of T = 37 °C and 100% humidity with a 5% concentration of CO2.
Samples of porous incubators were removed from the experiment and examined on days 1, 7, 14, and 21. After the removal, they were fixed for 1 h in 2.5% glutaraldehyde (Sigma-Aldrich, St. Louis, USA), then washed 3 times in PBS (15 min each), then fixed for 1 h in 1% osmium tetroxide (Sigma-Aldrich, St. Louis, USA), washed 3 times in PBS, and then dehydrated by passing through a series of ethanol solutions (30, 50, 70, 90, and 100%) for 15 min each. Each incubator sample was examined using a Quanta 200 3D scanning electron microscope (FEI, Hillsboro, USA).
2.5. Evisceration of the Eyeball
All procedures involving animals were carefully carried out with strict adherence to the Helsinki Declaration of 1975 and in accordance with the European Community’s Council Directive 86/609/EEC. The study protocol was officially approved (approval code number 138/1 of 16 March 2023) by the Bioethical Committee of Kuzbass Regional Clinical Hospital. The process of biointegration of an orbital implant made of modified porous TiNi was studied in in-vivo experiment on 20 animals (dogs). Anesthesia of laboratory animals participating in the experiment was carried out by intravenous administration of a solution of sodium thiopental (Sintez, Kurgan, Russia) combined with local infiltration anesthesia with a 2% solution of lidocaine hydrochloride (Grotex, Moscow, Russia).
Evisceration of the eyeball was performed according to the standard technique [
5]. An orbital implant was immersed into the prepared and properly treated scleral cavity, and scleral flaps were sutured in pairs with U-shaped sutures. Continuous sutures were placed in layers on Tenon's capsule, subconjunctiva and conjunctiva. The operation was completed with an antibiotic injection. Antibacterial therapy was carried out for 7 days. Animals were removed from the experiment by intravenous administration of a 10% lidocaine solution on days 10, 30, 90, and 180. Samples were removed from the animals and immersed in formaldehyde for further studies.
Orbital implant samples were dried on filter paper at room temperature, then placed on stages with electrically conductive tape for fixation, and loaded into the microscope column. The study of experimental samples was carried out on a Quanta 200 3D microscope (FEI, Hillsboro, USA) in a low-vacuum mode (at a pressure P = 70 Pa) using an LFD (Large Field Detector) for working with biological objects. The spatial resolution in this research mode, according to the microscope’s passport data, was 15 nm. The focal length was 10–20 mm, the tilt angle of the object stage was 0°. The accelerating voltage was 10–20 kV with the magnification from 36 to 15,000 times. Quantitative analysis of the chemical composition of tissues was performed using a microanalyzer EDAX ECON IV (EDAX, Mahwah, USA) with a silicon detector with a resolution of 120 eV. The state of the fibroformation process on the surface and on the chip of orbital implants was assessed by the microstructure of biological tissue.
4. Conclusions
This work reports on a porous SHS-prepared TiNi material for ophthalmological implants. Both the as-prepared and acid-modified porous materials with different states of the pore space and porosity coefficients were first thoroughly characterized. The modification method employed to modify the material’s surface morphology was based on chemical etching with removal of the Ti2Ni and Ti4Ni2(O,C) secondary-phase particles located on the pore wall surfaces.
It was demonstrated that after chemical etching there was an increase in the number of micropores less than 100 nm in size. After etching, the obtained rough surface of pore walls was more suitable for the attachment and development of cell cultures. In-vitro studies of the dynamics of integration of cellular material showed that cell growth and integration were improved on the acid-treated material with rougher surface of its pore walls.
Bio-integration of an orbital implant made of the acid-modified porous-permeable TiNi was also studied in vivo, and the reaction to its presence by body tissues was monitored over time. The process of integration of such a porous permeable implant was found to be accompanied by a high degree of adhesion of cellular and tissue structures of newly formed tissues into the material’s pore space. Formation of a reliable connection between the implant and surrounding anatomical structures was ensured within one month after surgery.
Thus, the high ability for bio-integration in a combination with its good framework properties make the novel acid-modified porous-permeable TiNi an attractive material for creating orbital implants for the formation of musculoskeletal stumps of the eyeball after evisceration. The material demonstrated a high degree of integration and tissue-implant connections, which is expected to provide its strong fixation in tissues, stable volume and shape of the musculoskeletal stump of the eyeball, and reduced risk of exposure and rejection of the implant.
Author Contributions
Conceptualization, S.G.A. and V.N.H.; methodology, M.I.K.; validation, S.A.K. and A.V.S.; soft-ware, S.A.K., N.V.A and A.V.S.; visualization, E.N.T. and A.V.S.; formal analysis, S.A.K. and E.A.B.; investigation, S.G.A., V.N.H., N.V.A, E.N.T. and M.I.K.; resources, V.N.H.; data curation, S.P., V.P. and Y.A.M.; writing—original draft preparation, S.G.A.; writing—review and editing, S.G.A., A.V.S., S.A.K. and V.N.H.; supervision, V.E.G; project administration, S.G.A.; funding acquisition, S.G.A. All authors have read and agreed to the published version of the manuscript.
Figure 1.
SEM image (BSE mode) of a thin section of porous SHS-prepared TiNi alloy showing macrostructure of the pore space. In inset: 1 is for longitudinal direction, and 2 for transverse direction.
Figure 1.
SEM image (BSE mode) of a thin section of porous SHS-prepared TiNi alloy showing macrostructure of the pore space. In inset: 1 is for longitudinal direction, and 2 for transverse direction.
Figure 2.
(a) SEM image (SE mode) showing surface morphology of porous SHS-prepared TiNi alloy. (b,c) Histograms of pore size (b) and of interpore bridge size (c) distribution in the porous TiNi alloy.
Figure 2.
(a) SEM image (SE mode) showing surface morphology of porous SHS-prepared TiNi alloy. (b,c) Histograms of pore size (b) and of interpore bridge size (c) distribution in the porous TiNi alloy.
Figure 3.
(a) SEM image (SE mode) showing a fractogram of destructed interpore bridge of porous SHS-prepared TiNi alloy; (b) EDX spectrum of the surface layer of the interpore bridge (taken at the point marked with cross in panel (a)); (c) histogram of micropore size distribution for the same sample.
Figure 3.
(a) SEM image (SE mode) showing a fractogram of destructed interpore bridge of porous SHS-prepared TiNi alloy; (b) EDX spectrum of the surface layer of the interpore bridge (taken at the point marked with cross in panel (a)); (c) histogram of micropore size distribution for the same sample.
Figure 4.
(a) XRD pattern of as-prepared porous SHS-produced TiNi alloy; (b) SEM image (BSE) of a thin section of porous SHS-prepared TiNi alloy showing phase distribution in the TiNi matrix.
Figure 4.
(a) XRD pattern of as-prepared porous SHS-produced TiNi alloy; (b) SEM image (BSE) of a thin section of porous SHS-prepared TiNi alloy showing phase distribution in the TiNi matrix.
Figure 5.
SEM images (BSE mode) of pore wall surface after first (a) and second (b) stages of etching.
Figure 5.
SEM images (BSE mode) of pore wall surface after first (a) and second (b) stages of etching.
Figure 6.
(a) SEM image (BSE mode) of the surface of pore walls, (b) histogram of pore size distribution, XRD pattern (c), and histogram of the micropore size distribution (d) in the porous TiNi alloy after the third stage of etching (7–10 s).
Figure 6.
(a) SEM image (BSE mode) of the surface of pore walls, (b) histogram of pore size distribution, XRD pattern (c), and histogram of the micropore size distribution (d) in the porous TiNi alloy after the third stage of etching (7–10 s).
Figure 7.
SEM image (BSE mode) of the pore wall surface of porous TiNi alloy after etching for longer than 10 s.
Figure 7.
SEM image (BSE mode) of the pore wall surface of porous TiNi alloy after etching for longer than 10 s.
Figure 8.
SEM images (low-vacuum SE mode) of surface space surface of the modified TiNi after day 1 of cell cultivation. (a) Cells adhered on the surface; (b) cells attached to pore walls with opposite-directed pseudopodia.
Figure 8.
SEM images (low-vacuum SE mode) of surface space surface of the modified TiNi after day 1 of cell cultivation. (a) Cells adhered on the surface; (b) cells attached to pore walls with opposite-directed pseudopodia.
Figure 9.
SEM images (low-vacuum SE mode) of the pore space of modified TiNi on day 7 of cell cultivation (a, b) and on day 10 (c, d). (a) Superficial development and (b) volumetric development; (c) thin surface layer with pseudopodia; (d) thickening of fibers.
Figure 9.
SEM images (low-vacuum SE mode) of the pore space of modified TiNi on day 7 of cell cultivation (a, b) and on day 10 (c, d). (a) Superficial development and (b) volumetric development; (c) thin surface layer with pseudopodia; (d) thickening of fibers.
Figure 10.
SEM images (low-vacuum SE mode) of the morphology of cell culture observed on the surface of modified porous TiNi material after 14 (a, b) and 21 (c, d) days of cultivation. (а) Cells in small surface pores; (b) cells in large pores; (c) formed tissue adjacent to pore wall surface; (d) pore space is fully filled by high-density mature tissue.
Figure 10.
SEM images (low-vacuum SE mode) of the morphology of cell culture observed on the surface of modified porous TiNi material after 14 (a, b) and 21 (c, d) days of cultivation. (а) Cells in small surface pores; (b) cells in large pores; (c) formed tissue adjacent to pore wall surface; (d) pore space is fully filled by high-density mature tissue.
Figure 11.
SEM images (low-vacuum SE mode) of orbital implant made of acid-modified porous TiNi material after 10 days of implantation: (a) capsule around the implant and filling of pore space with connective tissues; (b) individual fibroblasts and cell clusters; (c) network of fibers of immature connective tissue.
Figure 11.
SEM images (low-vacuum SE mode) of orbital implant made of acid-modified porous TiNi material after 10 days of implantation: (a) capsule around the implant and filling of pore space with connective tissues; (b) individual fibroblasts and cell clusters; (c) network of fibers of immature connective tissue.
Figure 12.
SEM images (low-vacuum SE mode) of orbital implant made of modified porous TiNi material after 30 days of implantation: (a) collagen fibers with individual cells; (b) vessels on implant surface; (c) connective tissue in implant’s pores.
Figure 12.
SEM images (low-vacuum SE mode) of orbital implant made of modified porous TiNi material after 30 days of implantation: (a) collagen fibers with individual cells; (b) vessels on implant surface; (c) connective tissue in implant’s pores.
Figure 13.
SEM images (low-vacuum SE mode) of orbital implant made of modified porous TiNi material after 90 (a) and 180 (b, c) days of implantation: (a) tissue location in the pore space; (b) fully formed connective tissue; (c) vessels in a dense connective tissue.
Figure 13.
SEM images (low-vacuum SE mode) of orbital implant made of modified porous TiNi material after 90 (a) and 180 (b, c) days of implantation: (a) tissue location in the pore space; (b) fully formed connective tissue; (c) vessels in a dense connective tissue.