Effect of simulated lenticular debris on corneal endothelial cells: experimental study in rabbit eyes

Abstract

A study using live rabbits, with subsequent analysis of excised corneas stained with trypan blue/alizarin red, showing simulated swirling lenticular debris may contribute significantly to corneal endothelium damage during phacoemulsification.

Corneal endothelium protection provided by ophthalmic viscosurgical devices during phacoemulsification: experimental study in rabbit eyes

“…26 However, it is noteworthy that the comparison of the results of our study with OVD, with those of the group using simulated lenticular debris but no OVD in our previous study, showed significantly more CEC damage/loss in the no-OVD group (Table 2). 5 OVD is still recommended to minimize CEC damage/loss and prevent subsequent pseudophakic bullous keratopathy, especially for novice surgeons and complicated cases with endothelial corneal pathology, pseudoexfoliation syndrome, traumatic cataracts, hard cataracts, or a history of previous vitreoretinal surgery. 13 Although our study only evaluated 2 OVDs that fit into the categories of cohesive or dispersive, surgical techniques have emerged using combinations of different OVD types (or balanced salt solution and OVDs) to maximize the benefits and minimize the weaknesses of each device.…”

“…To simulate swirling lenticular debris, we used the same types of acrylic beads as in our previous study. 5 In brief, the beads were purchased from Hobby Lobby (https://www.hobbylobby.com). Previous characterization of the beads performed through light microscopy, as well as scanning electron microscopy coupled with energy dispersive X-ray spectroscopy, showed the diameter of the acrylic beads to be 0.95 ± 0.07 mm, with the main elemental composition of the surface being carbon, oxygen, aluminum, and titanium.…”

“…These corneas were included in our previous study evaluating the effect of lenticular debris on CECs, and were processed and analyzed using the same procedures described here. 5 For this analysis, the nonparametric Wilcoxon-Mann-Whitney test was used and the P value was adjusted for multiple comparisons using a Bonferroni correction due to the multiarm comparison. In all analyses, an adjusted P value less than 0.05 was considered statistically significant.…”

“…In our previous experiments, our group demonstrated that fluid flow alone is not responsible for significant CEC damage, that torsional ultrasound is associated with significantly less CEC damage/loss than classical longitudinal ultrasound, and that swirling lenticular debris causes significant mechanical damage to CECs. 3–5…”

“…ultrasound, and that swirling lenticular debris causes significant mechanical damage to CECs. [3][4][5] Ophthalmic viscosurgical devices (OVDs) represent one of the main tools used to minimize intraocular tissue damage during phacoemulsification. 6 Their viscous and elastic properties allow surgeons to maintain anterior chamber depth, visibility, and tissue protection; different types of OVDs can be carefully selected and used for different purposes.…”