From the Department of Ophthalmology (Choi), Jeju National University School of Medicine, Jeju, the Research Institute for Agriculture and Life Science (Cho), Seoul National University, the Department of Ophthalmology (Han), Seoul Metropolitan Government-Seoul National University Boramae Medical Center, and the Department of Ophthalmology (Han), Seoul National University College of Medicine, Seoul, South Korea.
From the Department of Ophthalmology (Choi), Jeju National University School of Medicine, Jeju, the Research Institute for Agriculture and Life Science (Cho), Seoul National University, the Department of Ophthalmology (Han), Seoul Metropolitan Government-Seoul National University Boramae Medical Center, and the Department of Ophthalmology (Han), Seoul National University College of Medicine, Seoul, South Korea.
J Cataract Refract Surg. 2018 Oct;44(10):1254-1260. doi: 10.1016/j.jcrs.2018.04.043. Epub 2018 Aug 20.
To evaluate the effectiveness of thermoreversible (poloxamer) hydrogels as a substitute for ophthalmic viscosurgical devices (OVDs) during phacoemulsification in porcine and rabbit eyes and compare their endothelial protective effect with that of hyaluronic acid-based OVDs.
Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
Experimental study.
Fluorescein-stained poloxamer hydrogels (20%, 22%, 24%, and 26% [weight/weight%]) and cohesive (sodium hyaluronate 1.0% [Provisc]) and dispersive (sodium hyaluronate 3.0%-chondroitin sulfate 4.0% [Viscoat]) OVDs were injected into the anterior chamber of porcine eyes incubated at 32°C. In the in vitro study, the retention time was measured in 3 groups of 45 porcine eyes during continuous phacoemulsification. In the in vivo study, the endothelial cell count (ECC) was measured before and 3 days after intermittent phacoemulsification in 12 rabbit eyes randomized to a poloxamer hydrogel or a dispersive OVD group.
The optimum concentration of thermosensitive hydrogel was 26%, at which no gel-to-sol phase transition occurred in the anterior chamber, with a 21°C irrigation solution. In the in vitro study, the mean retention times were 5.53 seconds ± 1.77 (SD), 125.00 ± 29.34 seconds, and 221.53 ± 42.48 seconds in the cohesive OVD, dispersive OVD, and 26% poloxamer hydrogel groups, respectively (P < .001). Throughout the 5-minute intermittent phacoemulsification, the 26% poloxamer hydrogel remained in the anterior chamber as a semisolid gel. In the in vivo study, the mean decrease in ECC was significantly lower in the 26% poloxamer hydrogel group than in the dispersive OVD group (P = .029).
Thermoreversible hydrogels might be suitable substitutes for hyaluronic acid-based OVDs for corneal endothelial protection during phacoemulsification.
评估温敏（泊洛沙姆）水凝胶作为眼黏弹剂（OVD）在猪和兔眼超声乳化术中的替代品的效果，并比较其与基于透明质酸的 OVD 的内皮保护作用。
韩国首尔市立大学首尔圣母医院眼科。
实验研究。
将荧光素染色的泊洛沙姆水凝胶（20%、22%、24%和 26%[重量/重量%]）和黏合性（透明质酸钠 1.0%[Provisc]）以及弥散性（透明质酸钠 3.0%-硫酸软骨素 4.0%[Viscoat]）OVD 注入 32°C 孵育的猪眼前房。在体外研究中，在连续超声乳化过程中，在 45 只猪眼的 3 组中测量保留时间。在体内研究中，将 12 只兔眼随机分为泊洛沙姆水凝胶或弥散性 OVD 组，在间歇性超声乳化前后 3 天测量内皮细胞计数（ECC）。
最适温度敏感水凝胶浓度为 26%，在此浓度下，在前房内不会发生凝胶-溶胶相变，冲洗液温度为 21°C。在体外研究中，黏合性 OVD、弥散性 OVD 和 26%泊洛沙姆水凝胶组的平均保留时间分别为 5.53±1.77（SD）秒、125.00±29.34 秒和 221.53±42.48 秒（P<.001）。在整个 5 分钟间歇性超声乳化过程中，26%泊洛沙姆水凝胶在前房内保持为半固体凝胶。在体内研究中，26%泊洛沙姆水凝胶组的 ECC 平均下降量明显低于弥散性 OVD 组（P=.029）。
温敏水凝胶可能是超声乳化术中替代基于透明质酸的 OVD 以保护角膜内皮的合适替代品。
