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sylvain auriol, laurence mahieu, françois malecaze, véronique mathis; Evaluation Of Medium-chain Triglycerides As An Intraoocular Tamponading Agent In An Experimental Vitrectomy Model Rabbit. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3766.
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The management of several eye disorders such as rhegmatogenous retinal detachment routinely requires surgical removal of the vitreous and replacement with an intraocular tamponading agent. Although silicone oil is removed carefully and early, many complications can occur due to residual droplets persisting in the vitreous cavity following removal. Medium chain triglycerides (MCT), which are spontaneously bioresorbable and have no known biological activity, could be an innovative and potentially safer alternative intraocular tamponading agent. The aim of the study was to evaluate the safety of MCT used as an intraocular tamponading agent in an experimental vitrectomy model rabbit.
We performed a 20-gauge pars plana vitrectomy with posterior vitreous detachment in the right eye of 28 New Zealand White rabbits. Approximately 1 ml of MCT was then injected into the vitreous cavity. Post-operatively ophthalmologic examinations were performed weekly. At day 7, 30, 60 and 90 seven rabbits were sacrificed and the treated eyes were examined macroscopically and prepared for histological examination. The left eye served as control. The principal outcome was retinal toxicity and secondary outcomes were the presence of MCT emulsification, inflammatory reactions and the development of cataract.
The MCT were successfully injected, and remained translucent in the vitreous cavity throughout the postoperative period. Histological examination (light and electron microscopy) revealed no evidence of retinal toxicity. Two cases of moderate MCT emulsification induced by the perioperative injection did not increase during the post-operative period. Inflammatory reactions, mostly mild and localized within the residual inferior vitreous were noted in 13 eyes at 1 week with a subsequent gradual decrease and no anterior chamber involvement. Two eyes developed cataract due to perioperative lens trauma and not secondary to the presence of MCT in the vitreous cavity.
MCT display favorable physical properties for use as intraocular tamponade. Despite an early inflammatory response, MCT did not induce morphological evidence of retinal toxicity when in direct contact with inner retina. The results suggest that MCT could be a promising alternative intraocular tamponading agent for the treatment of retinal detachments. MCT will soon be evaluated in a pilot study in humans.
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