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Shlomit Schaal, Betty M Nunn, Agustina Palacio, Huayi Lu, Denis Jusufbegovic, AHMET OZKOK, Douglas Kenneth Sigford, Martin G O’Toole; testing of a Novel Antioxidant Biogel for Prevention of Post-vitrectomy Cataracts. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3216.
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© ARVO (1962-2015); The Authors (2016-present)
To test in vivo applicability and safety of a novel photo-polymerizable antioxidant biogel coating procedure developed to prevent the oxidative damage of the crystalline lens after vitrectomy.
The biogel was formulated with addition of hyaluronic Acid (HA), and antioxidant trehalose particles to a polyethylene glycol diacrylate (PEG-DA) base. A visible light photoinitiator system precipitated gel polymerization. Intraoperative applicability, safety and efficacy of the gel coating to prevent cataract formation following vitrectomy was tested in-vivo in 11 pigs. 25 G vitrectomies were performed, and 150 μL of gel was spread over the posterior surface of the lens. An uncoated but vitrectomized fellow eye was taken as control. Ocular exams were done on post-operative days 0, 1, 7, 28, 60, 90 & 180. Electroretinogram (ERG) of the each eye was obtained and compared before and after the surgery. At pre-determined time points of 1, 3, and 6 months animals were euthanized and lenses were recovered to grade the lens opacity by determining the clarity of a background Amsler grid with ImageJ software and also to extract the lens proteins to assess the amount of protein oxidation (OxyBlot Oxidized Protein Detection Kit,Chemicon, International, Billerica, MA).
Formulated biogel successfully prevented cataract formation in 7 of 11 (64%) eyes following vitrectomy surgery. Four of 11 (36%) eyes suffered iatrogenic cataract formation due to the inadvertent lens trauma during the coating process. Significantly increased “Visibility Scores” were attained in eyes where the lens was coated. Western blot revealed a greater degree of protein oxidation in the control (vs. treated) samples. No inflammation, IOP increase, lens dislocation or harmful adverse effects were noted during the clinical and electrophysiological exam.
Formulated biogel is biocompatible, non-immunogenic, and well tolerated. No acute toxicity, pressure increases, or other adverse effects were detected in association with the biogel. Current application method requires a learning curve and can be improved; however, the porcine surgical model has shown promising results revealing that formulated biogel can prevent oxygen-induced cataract formation after vitrectomy surgery.
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