BACKGROUND: The use of dispersive ophthalmic viscosurgical devices (OVDs) has been shown to provide significant protection against air bubble damage to the corneal endothelium when compared with cohesive OVDs. We compared the corneal endothelial protective effects of a new dispersive OVD, Healon-D, with Viscoat. METHODS: Healon-D and Viscoat were used in a randomized and masked fashion in the anterior chamber of 40 rabbit eyes during a procedure where ultrasound at 70% continuous energy was delivered for 2 min. Two millilitres of air bubbles were injected into the anterior chamber during the first minute of the procedure on each eye. Corneas were then stained with trypan blue and alizarin red and evaluated via light microscopy for endothelial injury. Both denuding of the endothelial layer, as well as damage to endothelial cells were quantified by using the Evaluation of Posterior Capsule Opacification digital imaging system. RESULTS: The denuded area for eyes treated with Healon-D and Viscoat were not significantly different (medians of 0.004167and 0.003333, respectively, P = 0.8908). There was no significant difference in the area of endothelial cell damaged (medians of 0.02183 and 0.01433, respectively, P = 0.4565). When the denuded and damaged areas were calculated together, there was also no difference in the total injured area (medians of 0.05817 and 0.05821, respectively, P = 0.5740). CONCLUSION: The new dispersive OVD Healon-D is equally as effective as Viscoat in protecting the corneal endothelial layer from denuding and damage from air bubbles during anterior segment surgery.
BACKGROUND: The use of dispersive ophthalmic viscosurgical devices (OVDs) has been shown to provide significant protection against air bubble damage to the corneal endothelium when compared with cohesive OVDs. We compared the corneal endothelial protective effects of a new dispersive OVD, Healon-D, with Viscoat. METHODS: Healon-D and Viscoat were used in a randomized and masked fashion in the anterior chamber of 40 rabbit eyes during a procedure where ultrasound at 70% continuous energy was delivered for 2 min. Two millilitres of air bubbles were injected into the anterior chamber during the first minute of the procedure on each eye. Corneas were then stained with trypan blue and alizarin red and evaluated via light microscopy for endothelial injury. Both denuding of the endothelial layer, as well as damage to endothelial cells were quantified by using the Evaluation of Posterior Capsule Opacification digital imaging system. RESULTS: The denuded area for eyes treated with Healon-D and Viscoat were not significantly different (medians of 0.004167and 0.003333, respectively, P = 0.8908). There was no significant difference in the area of endothelial cell damaged (medians of 0.02183 and 0.01433, respectively, P = 0.4565). When the denuded and damaged areas were calculated together, there was also no difference in the total injured area (medians of 0.05817 and 0.05821, respectively, P = 0.5740). CONCLUSION: The new dispersive OVD Healon-D is equally as effective as Viscoat in protecting the corneal endothelial layer from denuding and damage from air bubbles during anterior segment surgery.
Authors: Rhett S Thomson; Brian A Bird; Lance A Stutz; Joshua B Heczko; Ashlie A Bernhisel; William R Barlow; Brian Zaugg; Randall J Olson; Jeff H Pettey Journal: Clin Ophthalmol Date: 2019-04-12