Application of thermoreversible hydrogel (poloxamer 407) to protect the corneal endothelium during phacoemulsification in porcine and rabbit eyes

摘要

PurposeTo evaluate the effectiveness of thermoreversible (poloxamer) hydrogels as a substitute for ophthalmic viscosurgical devices (OVDs) during phacoemulsification in porcine and rabbit eyes and compare their endothelial protective effect with that of hyaluronic acid–based OVDs. SettingDepartment of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea. DesignExperimental study. MethodsFluorescein-stained poloxamer hydrogels (20%, 22%, 24%, and 26% [weight/weight%]) and cohesive (sodium hyaluronate 1.0% [Provisc]) and dispersive (sodium hyaluronate 3.0%–chondroitin sulfate 4.0% [Viscoat]) OVDs were injected into the anterior chamber of porcine eyes incubated at 32°C. In the in?vitro study, the retention time was measured in 3 groups of 45 porcine eyes during continuous phacoemulsification. In the in?vivo study, the endothelial cell count (ECC) was measured before and 3?days after intermittent phacoemulsification in 12 rabbit eyes randomized to a poloxamer hydrogel or a dispersive OVD group. ResultsThe optimum concentration of thermosensitive hydrogel was 26%, at which no gel-to-sol phase transition occurred in the anterior chamber, with a 21°C irrigation solution. In the in?vitro study, the mean retention times were 5.53?seconds?±?1.77 (SD), 125.00?±?29.34?seconds, and 221.53?±?42.48?seconds in the cohesive OVD, dispersive OVD, and 26% poloxamer hydrogel groups, respectively (P?