Protective Efficacy of Sodium Hyaluronate on the Corneal Endothelium Against the Damage Induced by Sonication

Abstract

The protective efficacy of sodium hyaluronate (Na-HA) on the corneal endothelium against the damage induced by sonication was investigated using enucleated rabbit eyes and Na-HA fluorescence labeled with 5-aminofluorescein (FA-HA). The anterior chamber was reformed by injecting a 1% solution of FA-HA, and then sonication, irrigation and aspiration were performed in the anterior chamber using a phaco-needle attached to phacoemulsification and aspiration (PEA) equipment. The protective efficacy was evaluated by the area of damaged corneal endothelium. When the anterior chamber was reformed by the solution of FA-HA with a molecular weight of 2010 x 10(3) (FA-HA (2010 x 10(3) group), most of the FA-HA was eliminated within 20 seconds after starting the irrigation and aspiration, and the area of damaged endothelium was the same with the case when the FA-HA was not pre-injected (Control group). On the other hand, when the anterior chamber was reformed by the solution of FA-HA with a molecular weight of 1130 x 10(3) (FA-HA (1130 x 10(3) group), the FA-HA was gradually eliminated after mixing with an irrigating solution, and the area of damaged endothelium was significantly smaller than those of the Control and FA-HA (2010 x 10(3)) groups. These results suggest that the corneal endothelial damage induced by PEA can be avoided by pre-injecting a viscoelastic material which can remain in the anterior chamber during PEA.

Comparison of the Clinical Performance of Healon 5 and Healon in Phacoemulsification

“…The higher concentration of sodium hyaluronate in Healon 5 (2.3%) than in Healon (1%) may be the cause of the slightly greater increase of IOP, as also reported for Healon GV (24). The corneal endothelium does not seem to be particularly affected, either quantitatively or qualitatively; however, more closely focused studies with more detailed assessment of the endothelial population, and follow-up geared to a more scientifically-oriented judgement, may well confirm these preliminary findings, as well as those reported by other authors (25,26).…”

Alteration of free radical development by ophthalmic viscosurgical devices in phacoemulsification

“…Thus, Opegan has lower viscosity and longer retention than Healon. 18,19 This behavior was seen with the low setting. Opegan also showed significant suppression of the signals compared with Healon.…”

Synthetic Methodologies

“…In cataract surgery, a new technique known as phacoemulsification and aspiration (PEA) uses ultrasound to emulsify the nucleus of the opaque lens, which is then removed. Highly viscoelastic NaHA is used to protect the endothelium of the cornea from injury during PEA [176].…”