A cross-linked hyaluronic acid hydrogel (Healaflow®) as a novel vitreous substitute

Barth, Henrik; Crafoord, Sven; Andréasson, Sten; Ghosh, Fredrik

doi:10.1007/s00417-015-3256-z

Cited by 55 publications

(45 citation statements)

References 29 publications

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“…We have additionally reported retinal degeneration using this compound in a novel in vitro setup [25]. In contrast, further experiments with another potential vitreous substitute, Healaflow® (crosslinked hyaluronic acid) in an in vivo rabbit model, revealed excellent biocompatibility [26]. We here wanted to further elucidate the retinal inflammatory reactions elicited by vitrectomy and treatment with vitreous substitutes.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory responses after vitrectomy with vitreous substitutes in a rabbit model

Barth

Crafoord

Arnér

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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Purpose To investigate the inflammatory response of current and future potential vitreous substitutes in an experimental in vivo vitrectomy model. Methods Twenty-five gauge pars plana vitrectomy was performed in the right eye of 60 pigmented rabbits, with subsequent injection of 0.5-1.0 ml of Healaflow® (cross-linked hyaluronic acid, n = 12), Bio-Alcamid® (polyalkylimide, n = 8), silicone oil (n = 12), or balanced saline solution (BSS, n = 28). Postoperative clinical evaluation was performed; and the rabbits were sacrificed at 1 day, 1 week, or 1 month. The eyecups were then examined macroscopically; the retinas sectioned and stained with hematoxylin and eosin (Htx), and immunohistochemically labeled for glial fibrillary acidic protein (GFAP), CD45, galectin-3, CD68, and CD20. Unoperated left eyes from treated animals as well as eyes from untreated animals were used as controls. Results Vitrectomy without major complications was achieved in 46/60 eyes. The remaining 14 eyes were analyzed separately. One eye developed endophthalmitis after 1 week and was excluded. Eyes treated with Healaflow®, silicone oil, and BSS had a comparable appearance macroscopically and in Htx-stained sections, whereas Bio-Alcamid®-injected eyes exhibited increased macroscopic inflammation and severely affected retinas. GFAP upregulation was present in all treatment groups, most prominent in eyes treated with Bio-Alcamid® and silicone oil. Upregulation of CD45 and CD68 in the inner retina and vitreous space was most prominent with Bio-Alcamid® treatment, and these eyes together with their silicone oil-treated counterparts also displayed a stronger upregulation of CD20-labeled cells compared with remaining groups. General upregulation of galectin-3, mainly in the inner retina, was found in all groups. In eyes with perioperative complications, labeling of CD45, CD68, and especially GFAP was comparably high. Conclusions We here describe differences in the postsurgery inflammatory profiles of existing and potential vitreous substitutes. Bio-Alcamid® and silicone oil display severe signs of gliosis and inflammation, whereas Healaflow® elicits minimal reactions comparable with BSS, highlighting its potential application as a vitreous substitute in a future clinical setting.

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Section: Introductionmentioning

confidence: 99%

Inflammatory responses after vitrectomy with vitreous substitutes in a rabbit model

Barth

Crafoord

Arnér

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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“…And Vitreous tamponade aims to replace the natural vitreous body with vitreous substitutes to support the retina, promote the anatomical reduction of the retina and prevent the eyeball from shrinking [5,12]. But current discovered vitreous substitutes have short-term life-span and high toxicity causing severe complications in the eyes [13,14]. Specially, SO has been proved to be toxic for ciliary body and attribute to emulsificate in the eyeball, though SO has the most stable physical and chemical attributions among all the vitreous substitutes [15].…”

Section: Introductionmentioning

confidence: 99%

Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation

Zhang

Tian²,

Zhang³

et al. 2019

BMC Ophthalmol

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Background: Foldable capsular vitreous body (FCVB) was designed to treat severe retinal detachment. The aim of this study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body in 1-year follow-up. Methods: A retrospective analysis was conducted for 20 patients with severe ocular trauma or silicone oil (SO) dependent eyes underwent vitrectomy and FCVB implantation in a 1-year follow-up. All treated eyes were peformed clinical examinations involved the visual acuity (VA) examination, Goldmann applanation tonometer, noncontact specular microscopy, fundus photography, B-Scan examination and optical coherence tomography (OCT). The groups were compared with t-test and the McNemar-Bowker test. Results: In 1-year follow-up, 20 eyes were evaluated in the study. FCVB well supported the vitreous retina in all treated eyes, and 6 treated eyes achieved retinal reattachment 12 months after FCVB implantation. There were no significant differences in VA before and after FCVB implantation (P = 1.000). In addition, the postoperative IOP markedly elevated from the preoperative IOP of 12.90 ± 7.06 mmHg to 15.15 ± 3.36 mmHg (P = 0.000017). The intraocular pressure (IOP) of 10 eyes maintained at a normal level after surgeries. The other 10 eyes showed slightly lower IOP within the acceptable level. Though two patients developed keratopathy and ocular inflammation respectively, other treated eyes were symmetric with fellow eyes showing satisfactory appearance. Moreover, there was no SO emulsification or leakage happened in the observation. Conclusions: FCVB implantation was an effective and safe treatment in the eyes with severe retinal detachment.

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“…Intraocular use of Hyaluronate, including intravitreal use, was proved safe and nontoxic to retina [12,13]. We observed 16 cases of hyaluronate injection following subretinal fluid drainage.…”

Section: Discussionmentioning

confidence: 97%

Endoillumination aided scleral buckling combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment

Zhao

Wang

2019

Preprint

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Background: To evaluate the efficiency and safety of 25-gauge illumination aided scleral buckling surgery combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment Methods: This study was undertaken in a prospective, nonrandomized, and uncontrolled manner. Patients of rhegmatogenous retinal detachment were performed scleral buckling surgery with the aid of intraocular illumination and noncontact wide-angle viewing system. Hyaluronate was injected into the vitreous cavity to maintain intraocular pressure stable after subretinal fluid drainage through the external sclerotomy when necessary. Best corrected visual acuity(BCVA), intraocular pressure, fundus examination and complications were observed and recorded. Results: Twenty-eight consecutive patients (28 eyes) were enrolled. Subretinal fluid drainage and hyaluronate injection was performed in 12 eyes. The final reattachment ratio was 100%. BCVA increased after operation (P<0.001) and no significant difference was observed between preoperative and postoperative intraocular pressure (P=0.149). No iatrogenic retinal break, choroidal hemorrhage or endophthalmitis were observed. Conclusions: Endoillumination aided buckling surgery combined with intravitreal injection of hyaluronate could be an option for treatment of rhegmatogenous retinal detachment especially for the cases of highly elevated retina. Trial registration: ChiCTR1800020055. Retrospectively registered on December 12, 2018. Key words: Rhegmatogenous retinal detachment, scleral buckling, noncontact wide-angle viewing system, endoillumination, intravitreal injection of hyaluronate.

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A cross-linked hyaluronic acid hydrogel (Healaflow®) as a novel vitreous substitute

Cited by 55 publications

References 29 publications

Inflammatory responses after vitrectomy with vitreous substitutes in a rabbit model

Inflammatory responses after vitrectomy with vitreous substitutes in a rabbit model

Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation

Endoillumination aided scleral buckling combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment

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