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PD Lamar, V Fernandez, F Manns, N Nakagawa, M Weiser, F Malecaze, JM Parel; Antifibrosis Effect of Novel Gels in Anterior Ciliary Slerotomy (ACS) . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1115.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To assess safety and antifibrosis activity of crosslinked sodium hyaluronic acid (cSHA) based gels in ACS procedures. Methods:Of 24 rabbits, 4 were operated following Thornton’s (90% depth incision) and 20 following Fukasaku’s (100% depth) techniques (total peritomy, four 4mm long radial scleral incisions starting 0.5mm from the limbus). In the Fukasaku group, the scleral walls were widened with a modified Fukasaku cross-action forceps. A control group of 6 animals received BSS, a group of 2 received pure cSHA gel (Corneal SA, Paris) and 16 received a cSHA-hydrogel compound (Corneal SA, Paris), applied to each incision. 14 animals of this ongoing long-term study have been euthanized at 1 and 3 months for histology while the remaining cohort are being followed for histology at 6 and 9 months. Results:The IOP, cornea, iris, lens, vitreous and retina remained normal in all animals. Histology shows the incisions in control eyes to be healed whereas in cSHA eyes, the incisions remained open. Scleral shrinkage in the incision area can be observed in control animals confirming the regression observed in ACS patients that did not receive an implant. Animals that received pure cSHA had open incision but the walls were very close one to another. In animals that received the cSHA-hydrogel compound, at 5 weeks the incisions are wide-open and filled with loose connective tissues ands mall hydrogel particles. No fibrotic contraction could be found in animals that received pure cSHA gel or cSHA-hydrogel compound. Conclusion:This study confirms the anti-inflammatory/antifibrosis properties of cSHA as well as the potentials for hydrogels to maintain the walls of ACS incision apart avoiding the need for solid plug implants. It also showed the advantage of mechanically widening the incisions during the ACS procedures as it allows for incision of controlled depth and uniformity. Support: Henri and Flore Lesieur Foundation; Florida Lions Eye Bank; Australian Cooperative Research Centre (CRC) Scheme, CRC for Eye Research and Technology, Sydney.
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