Petroll W Matthew, Jafari Masoud, Lane Stephen S, Jester James V, Cavanagh H Dwight
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9057, USA.
J Cataract Refract Surg. 2005 Dec;31(12):2363-8. doi: 10.1016/j.jcrs.2005.05.032.
To develop and apply a new laboratory method for in vivo quantitative assessment of the retention of ophthalmic viscosurgical devices (OVDs) following phacoemulsification.
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Studies of both eyes of New Zealand White rabbits were performed. Six OVDs were evaluated: Provisc and Healon (both sodium hyaluronate 1%), Healon5 (sodium hyaluronate 2.3%), Amvisc Plus (sodium hyaluronate 1.6%), Viscoat (sodium hyaluronate 3%-chondroitin sulfate 4%), and a new viscous-dispersive OVD, DisCoVisc (sodium hyaluronate 3%-chondroitin sulfate 4%). The OVD was injected to fill the anterior chamber and a phacoemulsification needle inserted with the tip positioned just anterior to the lens capsule. Simulated phacoemulsification was performed for 1 minute using flow rates of 20, 40, and 60 mL/min; a vacuum level of 300 mm Hg; and ultrasound power of 60% using a Legacy phacoemulsification unit. The needle was removed, and silicone oil (1000 centistokes) was injected into the anterior chamber. The distance between the corneal endothelium and the OVD-silicone oil interface was measured using in vivo confocal microscopy through-focusing (CMTF).
Significant differences in residual thickness were found between the OVDs tested. Specifically, the residual thickness of both DisCoVisc (mean 324.5 microm +/- 163.7 [SD]) and Viscoat (251.4 +/- 100.9 microm) was significantly greater than that of Provisc (9.5 +/- 16.7 microm), Healon (3.8 +/- 11.3 microm), Healon5 (0.6 +/- 2.4 microm), and Amvisc Plus (65.6 +/- 134.0 microm) (P < .05, Dunn test). Ophthalmic viscosurgical device retention was greatest with DisCoVisc; however, there was no statistically significant difference between DisCoVisc and Viscoat in residual thickness. The flow rate did not have a significant effect on the residual thickness (Friedman 2-way analysis of variance by ranks).
Residual OVD thickness following simulated phacoemulsification could be quantitatively measured using in vivo CMTF. The results are consistent with human surgical experience in that the dispersive OVD (Viscoat) was better retained than the cohesive compounds. DisCoVisc, a new viscous-dispersive OVD, also showed retention compared with Viscoat under the experimental conditions.
研发并应用一种新的实验室方法，用于体内定量评估白内障超声乳化术后眼科粘弹剂（OVDs）的残留情况。
美国得克萨斯州达拉斯市德克萨斯大学西南医学中心眼科。
对新西兰白兔的双眼进行研究。评估了6种OVDs：Provisc和Healon（均为1%透明质酸钠）、Healon5（2.3%透明质酸钠）、Amvisc Plus（1.6%透明质酸钠）、Viscoat（3%透明质酸钠-4%硫酸软骨素）以及一种新型粘性分散型OVD——DisCoVisc（3%透明质酸钠-4%硫酸软骨素）。将OVD注入以填充前房，插入超声乳化针，使其尖端位于晶状体囊前方。使用Legacy超声乳化仪，以20、40和60 mL/min的流速、300 mmHg的真空度以及60%的超声功率进行1分钟的模拟超声乳化。拔出针头，向前房注入硅油（1000厘沲）。通过体内共聚焦显微镜聚焦（CMTF）测量角膜内皮与OVD-硅油界面之间的距离。
在所测试的OVDs之间发现残留厚度存在显著差异。具体而言，DisCoVisc（平均324.5微米±163.7[标准差]）和Viscoat（251.4±100.9微米）的残留厚度均显著大于Provisc（9.5±16.7微米）、Healon（3.8±11.3微米）、Healon5（0.6±2.4微米）和Amvisc Plus（65.6±134.0微米）（P<.05，Dunn检验）。DisCoVisc的眼科粘弹剂残留量最大；然而，DisCoVisc和Viscoat在残留厚度方面无统计学显著差异。流速对残留厚度无显著影响（Friedman双向秩方差分析）。
可使用体内CMTF定量测量模拟超声乳化术后的OVD残留厚度。结果与人类手术经验一致，即分散型OVD（Viscoat）比粘性型化合物保留得更好。在实验条件下，新型粘性分散型OVD DisCoVisc与Viscoat相比也显示出有残留。
