A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector During Cataract Surgery

Overview

Journal J Ophthalmol

Publisher Wiley

Specialty Ophthalmology

Date 2017 May 4

PMID 28465835

Authors

Annabel C Y Chew

Anita Chan

Monisha E Nongpiur

Gary Peh

Veluchamy A Barathi

Nyein C Lwin

Charles Ong

Shamira Perera

Affiliations

Soon will be listed here.

Abstract

. We evaluated the efficacy and safety of a mechanical device, the P-chute, in corneal endothelium preservation during phacoemulsification in a rabbit model. . Twenty-four rabbits were randomly assigned into 2 groups. One eye of each rabbit underwent phacoemulsification that simulated the removal of a dense nucleus, with or without the P-chute. Serial slit-lamp examinations, anterior segment optical coherence tomography (ASOCT) scans, and specular microscopy were performed. Three rabbits from each group were sacrificed on postoperative days (PODs) 1, 5, 7, and 14. Histological analysis of the corneas was performed. . There was a trend towards lesser endothelial cell loss for the P-chute group at POD1 (4.9% versus 12.5%, = 0.53), POD5 (10.4% versus 12.2%, = 0.77), and POD7 (10.5% versus 17.2%, = 0.52). There was no significant difference in the corneal thickness ( = >0.05) between the 2 groups. The insertion of the device was challenging. The use of the P-chute only added an extra 15% to the surgical time. . There was a trend towards better endothelium preservation with the P-chute even though the results were not statistically significant. We believe that the device could be useful in certain surgical situations. Further work is needed to improve the device insertion.

References

Walkow T, Anders N, Klebe S . Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters. J Cataract Refract Surg. 2000; 26(5):727-32. DOI: 10.1016/s0886-3350(99)00462-9. View

Dick H, Kohnen T, Jacobi F, JACOBI K . Long-term endothelial cell loss following phacoemulsification through a temporal clear corneal incision. J Cataract Refract Surg. 1996; 22(1):63-71. DOI: 10.1016/s0886-3350(96)80272-0. View

Van den Bruel A, Gailly J, Devriese S, Welton N, Shortt A, Vrijens F . The protective effect of ophthalmic viscoelastic devices on endothelial cell loss during cataract surgery: a meta-analysis using mixed treatment comparisons. Br J Ophthalmol. 2009; 95(1):5-10. DOI: 10.1136/bjo.2009.158360. View

Minkowski J, Bartels S, Delori F, Lee S, Kenyon K, Neufeld A . Corneal endothelial function and structure following cryo-injury in the rabbit. Invest Ophthalmol Vis Sci. 1984; 25(12):1416-25. View

Bourne W, Nelson L, Hodge D . Continued endothelial cell loss ten years after lens implantation. Ophthalmology. 1994; 101(6):1014-22; discussion 1022-3. DOI: 10.1016/s0161-6420(94)31224-3. View

Bourne R, Minassian D, Dart J, Rosen P, Kaushal S, Wingate N . Effect of cataract surgery on the corneal endothelium: modern phacoemulsification compared with extracapsular cataract surgery. Ophthalmology. 2004; 111(4):679-85. DOI: 10.1016/j.ophtha.2003.07.015. View

Fakhry M, El Shazly M . Torsional ultrasound mode versus combined torsional and conventional ultrasound mode phacoemulsification for eyes with hard cataract. Clin Ophthalmol. 2011; 5:973-8. PMC: 3141862. DOI: 10.2147/OPTH.S22879. View

VAN HORN D, Sendele D, Seideman S, Buco P . Regenerative capacity of the corneal endothelium in rabbit and cat. Invest Ophthalmol Vis Sci. 1977; 16(7):597-613. View

Peh G, Chng Z, Ang H, Cheng T, Adnan K, Seah X . Propagation of human corneal endothelial cells: a novel dual media approach. Cell Transplant. 2013; 24(2):287-304. DOI: 10.3727/096368913X675719. View

10.

Riau A, Tan N, Angunawela R, Htoon H, Chaurasia S, Mehta J . Reproducibility and age-related changes of ocular parametric measurements in rabbits. BMC Vet Res. 2012; 8:138. PMC: 3514359. DOI: 10.1186/1746-6148-8-138. View

11.

Zeng M, Liu X, Xia Y, Luo L, Yuan Z, Zeng Y . Torsional ultrasound modality for hard nucleus phacoemulsification cataract extraction. Br J Ophthalmol. 2008; 92(8):1092-6. PMC: 2569137. DOI: 10.1136/bjo.2007.128504. View

12.

Oshika T, Bissen-Miyajima H, Fujita Y, Hayashi K, Mano T, Miyata K . Prospective randomized comparison of DisCoVisc and Healon5 in phacoemulsification and intraocular lens implantation. Eye (Lond). 2010; 24(8):1376-81. DOI: 10.1038/eye.2010.47. View

13.

Hugod M, Storr-Paulsen A, Norregaard J, Nicolini J, Larsen A, Thulesen J . Corneal endothelial cell changes associated with cataract surgery in patients with type 2 diabetes mellitus. Cornea. 2011; 30(7):749-53. DOI: 10.1097/ICO.0b013e31820142d9. View

14.

Baradaran-Rafii A, Rahmati-Kamel M, Eslani M, Kiavash V, Karimian F . Effect of hydrodynamic parameters on corneal endothelial cell loss after phacoemulsification. J Cataract Refract Surg. 2009; 35(4):732-7. DOI: 10.1016/j.jcrs.2008.12.017. View

15.

Ben-Eliahu S, Tal K, Milstein A, Levin-Harrus T, Ezov N, Kleinmann G . Protective effect of different ophthalmic viscosurgical devices on corneal endothelial cells during phacoemulsification: rabbit model. J Cataract Refract Surg. 2010; 36(11):1972-5. DOI: 10.1016/j.jcrs.2010.05.023. View