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D.A. Ghate, G. Holley, H. Dollinger, K. Markwardt, J. Bullock, H.F. Edelhauser; Preservation of the Corneal Endothelial Mucin Layer With NGOIS – The Next Generation Ophthalmic Irrigating Solution . Invest. Ophthalmol. Vis. Sci. 2006;47(13):620.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate human corneal endothelial mucin layer thickness after phacoemulsification & irrigation/aspiration (I/A) with the Next Generation Ocular Irrigating Solution (NGOIS), which contains a polymer that modifies both surface tension and viscosity, so that it is similar to that of aqueous humor.
Paired human corneas (n = 14) were mounted in an artificial anterior chamber with a volume of 400 µL. Nine corneas were exposed to 3 minutes of ultrasound (US) at 80% power using the Alcon SERIES 20000® LEGACY® surgical system, followed by 250 mL of irrigation using NGOIS at a flow rate of 40 cc/min. Five corneas were exposed to 2 minutes of pulsed US at 50% power, 50 % of the time at 20 pps using the Alcon INFINITI® Vision System, followed by 250 mL of irrigation using NGOIS at a flow rate of 50 cc/min. The other corneas of the pairs were exposed to the same instrument settings using BSS PLUS®. The corneas were divided in half and fixed for mucin staining and transmission electron microscopy (TEM). The mucin layer thickness was measured on the TEM prints.
The mucin layer thickness in the continuous phacoemulsification group (3 min US, 80% power, SERIES 20000® LEGACY® surgical system) was 0.76 ± 0.28 µm (mean ± SD) with NGOIS and 0.52 ± 0.34 µm with BSS PLUS®. The difference was statistically significant (p =0.0003). The mucin layer thickness in the pulsed phacoemulsification group (2 min US, 50% power, 50 % of the time, 20 pps, INFINITI® Vision System) was 1.52 ± 0.43 µm (mean ± SD) with NGOIS and 1.09 ± 0.21 µm with BSS PLUS®. The difference was statistically significant (p = 0.00005).
In an in situ corneal model, NGOIS provides improved protection to the corneal endothelial mucin layer from the effects of phacoemulsification and I/A using both continuous and pulsed US at flow rates of 40 and 50 cc/min. The added polymer in NGOIS reduces surface tension and increases viscosity, allowing for both maintenance of the mucin layer attachment integrity and for a statistically significant difference in the post–phacoemulsification mucin layer thickness. The advantage of NGOIS was evident with both the INFINITI® Vision System and the SERIES 20000 ® LEGACY ® surgical system.
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