1
|
Wu B, Ding X, Li S, Huo D, Zhang F, Liang W, Li L, Dou Z. Mechanical protective effect of lens anterior capsule disc on corneal endothelial cells during femtosecond laser-assisted cataract surgery in a rabbit model. BMC Ophthalmol 2023; 23:166. [PMID: 37076866 PMCID: PMC10114485 DOI: 10.1186/s12886-023-02918-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
PURPOSE To evaluate the effects of a novel technique using an isolated lens anterior capsule disc (LACD) to protect corneal endothelial cells in rabbit eyes during femtosecond laser-assisted cataract surgery. METHODS Experimental study. 40 rabbits were divided into endothelium-protected (experimental) and control groups, with 20 rabbits in each group. In the experimental group, after femtosecond laser capsulotomy, the isolated capsule disc was lifted to the corneal endothelium by an ophthalmic viscosurgical device. The endothelium was damaged for 1 min with an ultrasonic probe. The control group underwent the same surgery, except that the disc was removed immediately after capsulorhexis. Corneal endothelioscopy was performed preoperatively and on postoperative days (PODs) 3 and 7 to observe endothelial cell counts (ECC) and endothelial cell loss rate. Central corneal thickness (CCT) was measured before and at PODs 1, 3 and 7. RESULTS There were 3.59%±1.88% (p < 0.001) and 2.92%±2.14% (p < 0.001) loss of ECC in experimental group at POD3 and POD7, respectively, while those in the control group were 11.62%±7.43% and 10.34%±5.77%, respectively. On POD 1, the difference in central corneal thickness was significant(P = 0.019) between the two groups. At POD 3 and POD 7, CCT was not significantly different (P = 0.597;0.913) between the two groups. CONCLUSIONS The isolated LACD technique significantly reduced damage to the endothelium caused by ultrasonic energy and protects corneal endothelial cells during phacoemulsification.
Collapse
Affiliation(s)
- Bowen Wu
- Aier School of Ophthalmology, Central South University, No.932, Lushan South Road, Changsha, Hunan province, China
| | - Xue Ding
- Beijing Aier-Intech Eye Hospital, Beijing, China
| | - Shaowei Li
- Aier School of Ophthalmology, Central South University, No.932, Lushan South Road, Changsha, Hunan province, China.
- Beijing Aier-Intech Eye Hospital, Beijing, China.
- Institute of Corneatology in Aier Eye Hospital, Beijing, China.
| | - Dongmei Huo
- Beijing Aier-Intech Eye Hospital, Beijing, China
| | - Fan Zhang
- Aier School of Ophthalmology, Central South University, No.932, Lushan South Road, Changsha, Hunan province, China
| | - Weiyan Liang
- Tianjin University Aier Eye Hospital, Tianjin, China
| | - Ling Li
- Beijing Aier-Intech Eye Hospital, Beijing, China
- Institute of Corneatology in Aier Eye Hospital, Beijing, China
| | - Zexia Dou
- Beijing Aier-Intech Eye Hospital, Beijing, China
- Institute of Corneatology in Aier Eye Hospital, Beijing, China
| |
Collapse
|
2
|
D'ambrosio S, Alfano A, Cassese E, Restaino OF, Barbuto Ferraiuolo S, Finamore R, Cammarota M, Schiraldi C, Cimini D. Production and purification of higher molecular weight chondroitin by metabolically engineered Escherichia coli K4 strains. Sci Rep 2020; 10:13200. [PMID: 32764548 PMCID: PMC7411012 DOI: 10.1038/s41598-020-70027-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022] Open
Abstract
The capsular polysaccharide obtained from Escherichia coli K4 is a glycosaminoglycan-like molecule, similar to chondroitin sulphate, that has established applications in the biomedical field. Recent efforts focused on the development of strategies to increase K4 polysaccharide fermentation titers up to technologically attractive levels, but an aspect that has not been investigated so far, is how changes in the molecular machinery that produces this biopolymer affect its molecular weight. In this work, we took advantage of recombinant E. coli K4 strains that overproduce capsular polysaccharide, to study whether the inferred pathway modifications also influenced the size of the produced polymer. Fed-batch fermentations were performed up to the 22 L scale, in potentially industrially applicable conditions, and a purification protocol that allows in particular the recovery of high molecular weight unsulphated chondroitin, was developed next. This approach allowed to determine the molecular weight of the purified polysaccharide, demonstrating that kfoF overexpression increased polymer size up to 133 kDa. Higher polysaccharide titers and size were also correlated to increased concentrations of UDP-GlcA and decreased concentrations of UDP-GalNAc during growth. These results are interesting also in view of novel potential applications of higher molecular weight chondroitin and chondroitin sulphate in the biomedical field.
Collapse
Affiliation(s)
- S D'ambrosio
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - A Alfano
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - E Cassese
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - O F Restaino
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - S Barbuto Ferraiuolo
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - R Finamore
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - M Cammarota
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - C Schiraldi
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy
| | - D Cimini
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, University of Campania L. Vanvitelli, via de Crecchio 7, 80138, Napoli, Italy.
| |
Collapse
|
3
|
Choi JY, Cho CS, Han YK. Application of thermoreversible hydrogel (poloxamer 407) to protect the corneal endothelium during phacoemulsification in porcine and rabbit eyes. J Cataract Refract Surg 2018; 44:1254-1260. [PMID: 30139637 DOI: 10.1016/j.jcrs.2018.04.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/06/2018] [Accepted: 04/20/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE To 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. SETTING Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea. DESIGN Experimental study. METHODS Fluorescein-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. RESULTS The 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 < .001). Throughout the 5-minute intermittent phacoemulsification, the 26% poloxamer hydrogel remained in the anterior chamber as a semisolid gel. In the in vivo study, the mean decrease in ECC was significantly lower in the 26% poloxamer hydrogel group than in the dispersive OVD group (P = .029). CONCLUSION Thermoreversible hydrogels might be suitable substitutes for hyaluronic acid-based OVDs for corneal endothelial protection during phacoemulsification.
Collapse
Affiliation(s)
- Jung Yeol Choi
- From the Department of Ophthalmology (Choi), Jeju National University School of Medicine, Jeju, the Research Institute for Agriculture and Life Science (Cho), Seoul National University, the Department of Ophthalmology (Han), Seoul Metropolitan Government-Seoul National University Boramae Medical Center, and the Department of Ophthalmology (Han), Seoul National University College of Medicine, Seoul, South Korea
| | - Chong-Su Cho
- From the Department of Ophthalmology (Choi), Jeju National University School of Medicine, Jeju, the Research Institute for Agriculture and Life Science (Cho), Seoul National University, the Department of Ophthalmology (Han), Seoul Metropolitan Government-Seoul National University Boramae Medical Center, and the Department of Ophthalmology (Han), Seoul National University College of Medicine, Seoul, South Korea
| | - Young Keun Han
- From the Department of Ophthalmology (Choi), Jeju National University School of Medicine, Jeju, the Research Institute for Agriculture and Life Science (Cho), Seoul National University, the Department of Ophthalmology (Han), Seoul Metropolitan Government-Seoul National University Boramae Medical Center, and the Department of Ophthalmology (Han), Seoul National University College of Medicine, Seoul, South Korea.
| |
Collapse
|
4
|
A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector during Cataract Surgery. J Ophthalmol 2017; 2017:6906139. [PMID: 28465835 PMCID: PMC5390626 DOI: 10.1155/2017/6906139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/16/2016] [Accepted: 11/23/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. We evaluated the efficacy and safety of a mechanical device, the P-chute, in corneal endothelium preservation during phacoemulsification in a rabbit model. Methods. Twenty-four rabbits were randomly assigned into 2 groups. One eye of each rabbit underwent phacoemulsification that simulated the removal of a dense nucleus, with or without the P-chute. Serial slit-lamp examinations, anterior segment optical coherence tomography (ASOCT) scans, and specular microscopy were performed. Three rabbits from each group were sacrificed on postoperative days (PODs) 1, 5, 7, and 14. Histological analysis of the corneas was performed. Results. There was a trend towards lesser endothelial cell loss for the P-chute group at POD1 (4.9% versus 12.5%, p = 0.53), POD5 (10.4% versus 12.2%, p = 0.77), and POD7 (10.5% versus 17.2%, p = 0.52). There was no significant difference in the corneal thickness (p = >0.05) between the 2 groups. The insertion of the device was challenging. The use of the P-chute only added an extra 15% to the surgical time. Conclusions. There was a trend towards better endothelium preservation with the P-chute even though the results were not statistically significant. We believe that the device could be useful in certain surgical situations. Further work is needed to improve the device insertion.
Collapse
|
5
|
Effects of senofilcon A mechanical protector on corneal endothelial cells during phacoemulsification in rabbit eyes: Pilot study. J Cataract Refract Surg 2017; 43:394-399. [DOI: 10.1016/j.jcrs.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/31/2016] [Accepted: 01/02/2017] [Indexed: 11/23/2022]
|
6
|
Buschschlüter S, von Eicken J, Koch C, Höh H. Experimental and Numerical Determination of the Local Temperature Distribution during Phacoemulsification and Comparison of Different Surgery Situations within Enucleated Porcine Eyes. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:2161-2172. [PMID: 25944286 DOI: 10.1016/j.ultrasmedbio.2015.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/07/2015] [Accepted: 03/27/2015] [Indexed: 06/04/2023]
Abstract
Phacoemulsification, a common treatment for cataract, is accompanied by cell damage at the corneal endothelium. Thermal exposure during treatment has been considered a reason for this damage, but a thorough experimental and theoretical assessment of the local temperature distribution inside the eye had not yet been conducted. Measurements in porcine eyes and a finite-element simulation enabled such an assessment and localized the highest temperature rise very close to the probe. The results described in this study indicate that a distance of 1 mm between the probe and the endothelium should be maintained during treatment as a safety margin, especially when fluid flow is blocked. The highest measured temperature rise with surgically reasonable system settings and unblocked fluid flow was 1.11°C. The finite-element simulation described here is able to calculate the temperature rise at the endothelium and could serve as a tool for comparing arbitrary surgical situations with respect to thermal exposure of the endothelium.
Collapse
Affiliation(s)
| | - Jörn von Eicken
- Klinik für Augenheilkunde, Dietrich-Bonhoeffer-Klinikum, Neubrandenburg, Germany
| | - Christian Koch
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | - Helmut Höh
- Klinik für Augenheilkunde, Dietrich-Bonhoeffer-Klinikum, Neubrandenburg, Germany
| |
Collapse
|
7
|
Labiris G, Sideroudi H, Rousopoulos K, Kozobolis VP. Cohesive versus dispersive-cohesive ophthalmic viscosurgical device in torsional intelligent phaco. J Cataract Refract Surg 2015; 41:681-2. [PMID: 25804586 DOI: 10.1016/j.jcrs.2015.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/10/2015] [Indexed: 12/01/2022]
|
8
|
Kretz FT, Limberger IJ, Auffarth GU. Corneal endothelial cell coating during phacoemulsification using a new dispersive hyaluronic acid ophthalmic viscosurgical device. J Cataract Refract Surg 2014; 40:1879-84. [DOI: 10.1016/j.jcrs.2014.04.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/23/2014] [Accepted: 04/23/2014] [Indexed: 11/25/2022]
|
9
|
Abstract
PURPOSE OF REVIEW Corneal endothelial cell loss remains a well known, undesirable side-effect of cataract surgery that may, in severe cases, negatively impact patients' postoperative visual outcomes. This article reviews the current literature and describes in detail how the degree of corneal endothelial cell loss is influenced by specific patient risk factors, as well as the arrival of newer surgical techniques and technologies. RECENT FINDINGS Recent studies have demonstrated a reduction in corneal endothelial cell loss after phacoemulsification with the use of viscoelastic materials and modifications in phacoemulsification technology. Some patient characteristics may predispose patients to increased endothelial cell loss during cataract surgery. SUMMARY Advances in surgical technique, the implementation of newer surgical technologies such as torsional ultrasound and viscoelastic devices, and aspects of patients' preexisting medical history may lead to varying degrees of endothelial cell loss after cataract surgery. Appropriately addressing these issues during the perioperative period may improve the rate of endothelial cell loss, and thus further enhance the visual outcome of patients undergoing cataract surgery.
Collapse
|
10
|
Knez N, Šiško K, Pahor D. Influence of Cataract Surgery on Macular Thickness — A 3-Month Follow-Up. J Int Med Res 2011; 39:1113-21. [DOI: 10.1177/147323001103900347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This prospective follow-up study evaluated the longer term changes to macular thickness and volume following cataract surgery. The study included 23 patients (23 eyes) who underwent ambulatory cataract surgery with phacoemulsification and intraocular lens implantation, followed by a scheduled optical coherence tomography measurement of macular thickness and volume after 3 months. Results were compared with preoperative data and measurements taken at 1 month after surgery, which were recorded in a previous study. A comparison of preoperative macular thickness values with those at 3 months after surgery demonstrated that the latter values remained greater in all macular regions except the superior outer macula, and that the differences were significant in the fovea, nasal inner macula and inferior outer macula. When macular thickness at 3 months after surgery was compared with that measured at 1 month, decreases were observed in all perifoveal areas, suggesting the reversible nature of cataract surgery-related macular thickness changes.
Collapse
Affiliation(s)
- N Knez
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - K Šiško
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - D Pahor
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Department of Ophthalmology, University Clinical Centre Maribor, Maribor, Slovenia
| |
Collapse
|