Abstract
Abstract: :
Purpose: To demonstrate the effect of sealing of the lens capsule in New Zealand White rabbit eye following lens removal. Postoperative proliferation of lens epithelial cells in the capsular bag remains the most frequent complication of cataract surgery. Intraocular infusion of cytotoxic drugs, anti–metabolites, or hyposmotic agents are not preferred during human cataract surgery due to potential risk of toxicity to corneal endothelium and other ocular tissues. Selective delivery of pharmacologic/hypo–osmotic agents into the capsular bag is now possible using a Sealed Capsule Irrigation (SCI) device that is manufactured from biomedical grade soft silicone. This device allows the surgeon to reseal the capsular bag intraoprtaively. We evaluated histological difference of fresh rabbit eyes using water and triton X for irrigation of the capsule with and without the use of SCI. Methods: A total of 14 rabbit eyes underwent cataract removal surgery. Half of these eyes were randomized to selective irrigation of the capsular bag using SCI with distilled water and triton X. The other half underwent non selective irrigation of the capsule without SCI. Three eyes were used as controls. When performed, Irrigation of the capsular bag was carried out with distilled water and triton X for 5 minutes using the SCI device (Perfect Capsule,TM Milvella Pty. Ltd., Sydney, Australia). The eyes were immediately fixed in 10% neutral buffered formalin and sent for histological analysis. Results: Intra–operatively, the capsular bag was sealed in all treatment eyes. Irrigation was able to be performed for 5 minutes using SCI. Without SCI, eyes showed significant histological damage to the cornea, iris and peripheral retina to irrigation with water and triton X. in the presence of SCI, eyes showed no collateral damage and only showed destruction of lens epithelial cells. Triton X causes almost complete destruction of lens epithelial cells..Conclusions: SCI allows selective delivery of drugs directly into the capsular bag preventing collateral damage to surrounding intraocular structures in a rabbit eye. The SCI device may allow the isolated safe delivery of pharmacological agents into the capsular bag during cataract surgery. Long–term studies and multi–centric clinical trials may be helpful to test its efficacy to prevent the postoperative cellular proliferation of lens epithelial cells in the capsular bag.
Keywords: posterior capsular opacification (PCO) • cataract • anterior segment