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Jonathon Young, Deborah Conklyn, Joseph Bogaard, Herbert Whiteley, Iris S Kassem; Inhibition of Fibrin and Inflammation with Enoxaparin and Triamcinolone in a Juvenile Rabbit Model of Lensectomy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3290.
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© ARVO (1962-2015); The Authors (2016-present)
To determine changes in the anterior chamber and aqueous humor after lensectomy with intraocular lens (IOL) insertion and how enoxaparin and triamcinolone affect these changes in a juvenile rabbit animal model.
All experiments were approved and in compliance with Animal Care Committees of the University of Illinois at Chicago and the Medical College of Wisconsin. Juvenile (6-7 week old) New Zealand White rabbits had clear-cornea lensectomy under general anesthesia with Simcoe irrigation and aspiration followed by IOL insertion (Alcon SN60WF 30D). Following wound closure, either balanced salt solution (control), 8mg of enoxaparin, 0.5mg of preservative-free triamcinolone, or a combination of enoxaparin and triamcinolone was placed into the anterior chamber. Topical antibiotic ointment was given for 3 days postoperatively. Postoperatively, rabbits were examined under sedation with slit lamp biomicroscopy. Aqueous fibrinogen and fibrin levels were quantified using solid phase-phase sandwich enzyme linked immunosorbent assay (TSZ ELISA™, Biotang Inc.). Histopathology was used to evaluate for fibrin membrane formation and inflammatory cells in the eye.
Lensectomy with IOL insertion resulted in fibrin clot formation and inflammation of the anterior chamber similar to previous reports (Bogaard and Kassem, Invest. Ophthalmol Vis. Sci. 2015; 56(7):3217. Anterior chamber fluid fibrin levels were not significantly higher in anterior chamber fluid in control rabbits with 9.04 +/- 1.65 mg/ml before surgery and 11.71 +/- 2.44 mg/ml (p>0.05). Pathology demonstrated increased fibrin in the anterior chamber with numerous heterophils (neutrophils in humans) in the anterior chamber. Fibrinogen was not detected in the anterior chamber of surgically naïve eyes, but increased postoperatively (89.49 ng/ml) with higher levels in enoxaparin treated eyes. On pathology, there were less heterophils in eyes treated with triamcinolone.
Enoxaparin reduces the formation of insoluble fibrin on the anterior chamber of eyes after lensectomy with IOL in a juvenile rabbit model while triamcinolone reduces inflammatory cells. Enoxaparin and triamcinolone may be used to prevent inflammation and fibrin formation after lensectomy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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