Purchase this article with an account.
Henrik Barth, Sven W Crafoord, Karin Arner, Fredrik K Ghosh; Cellular CD68 and CD45r0 positive inflammatory responses of vitrectomy with vitreous substitutes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5838.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Inflammation is one of the key adverse effects that may limit the usability of clinical and experimental vitreous substitutes. To investigate their inflammatory responses, two potential tamponades with different biocompatibility profiles (Healaflow® and Bio-Alcamid®) were compared to Balanced Saline Solution (BSS) in an experimental in vivo vitrectomy model.
25-gauge pars plana vitrectomy with posterior vitreous detachment was performed in the right eye of 36 pigmented rabbits, with subsequent injection of 0,5 - 1 ml of Healaflow®, Bio-Alcamid® (through an 18-gauge incision), or Balanced Saline Solution (BSS). Postoperative clinical evaluation was performed, and the rabbits were sacrificed at 1 day, 1 week, or 1 month. After enucleation, the eyes were examined macroscopically, and prepared for histological examination with routine microscopy and immunohistochemical analysis of CD68 and CD45r0 including the retina and remaining peripheral vitreous.
No differences in the amount of postoperative complications or morphology were seen between eyes subjected to Healaflow® and BSS. CD45r0 labelling was seen in the Ganglion Cell Layer and Inner Nuclear Layer in both operated and unoperated eyes. Infiltrating CD68+ cells were present in a majority of the retinas. All of the eyes treated with Bio-Alcamid® exhibited increased macroscopic inflammation, and cataract development. One of these eyes sustained endophtalmitis-like inflammation, and all these retinas were severely affected. Infiltrating CD68+ and large amounts of CD45r0+ cells were found in the vitreous, and in affected retinas.
In the eyes treated with Bio-Alcamid®, signs of an increased level of cellular inflammatory response (labelling with CD68 and CD45r0) were seen compared to eyes treated with Healaflow® or BSS. The increased inflammation might be caused by a foreign body response against the artificial polyalkyl-imide gel of Bio-Alcamid®. Healaflow®, on the other hand, is a cross-linked hyaluronic acid hydrogel with a structure and composition similar to the natural vitreous, which might account for its excellent biocompatibility. This pilot study suggest that activated T-cells (CD45r0+) and macrophages (CD68+) play a role in post-operative inflammation. An increased understanding of normal and pathological responses might aid in the development of more biocompatible vitreous substitutes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only