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Hiroki Hatanaka, Kentaro Kojima, Kazuhito Yoneda, Shigeru Kinoshita; Evaluation of The Safety and Stability of The Fillers in Supra Choroidal Buckling Using Rabbit Model. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4889.
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© ARVO (1962-2015); The Authors (2016-present)
Scleral buckling (SBP) is one of the surgical procedures for uncomplicated rhegmatogenous retinal detachment (RRD). Although SBP is widely conducted for primary RRDs, it may be invasive procedure and have some complications because of eternal direct depression of the sclera, such as double vision, astigmatism, circulatory disturbance. El Rayes et al reported (Retina. 33:1073-5, 2013.) the novel procedure for RRD and myopic traction maculopathy, supra choroidal buckling (SCB), and the good clinical outcome. On the other hand, the influence of the mass effect of the filler on the tissues around the supra choroidal space (SCS) is not examined. We investigated the influence using some fillers in the rabbit model.
Eighteen unilateral SCB surgeries were performed in the eighteen eyes of eighteen rabbits, using some fillers (Healon V®; n=6, Restylane® ; n=6, BSS® ; n=6). The fillers (0.03ml) were delivered into SCS at 3 papilla diameters from optic disc. The change of SCS was evaluated by OCT at 7, 21 days postoperatively. The choroidal perfusion was observed by indocyanine green angiography (IA) at 21 days after operation.
In the Healon V and Restylane group, the SCS was observed as dome region just after operation, while the flat space was observed in the BSS group. All of Healon V and BSS were not detected but Restylane was remained in SCS at 7 days postoperatively. Restylane was slightly decreased but made dome-shaped region at 21 days postoperatively. In one case of Restylene, the thinning of choroid and retina was observed. The hypo-perfusion area was detected by IA, but no discontinuation of choroidal vessels and choroidal hemorrhage were observed.
Healon V was absorbed in less than 7 days and Restylane was more stable than Healon V. There are possibilities of decreasing in choroidal circulation and tissue damage around the filler in the SCS and further investigations are required in long-term follow-up.
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