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Long C, Gao Q, Liu S, Chen Y, Song H, Yu J, Lou B, Yuan Z, Zheng Y, Zhong L, Qiao S, Meng X, Liu Y, Wang Y, Liu Y, Lin X, Yan H. Precise prediction of size of a foldable capsular vitreous body via computerized three-dimensional ocular reconstruction in severe retinal detachment. BMC Ophthalmol 2024; 24:412. [PMID: 39304858 DOI: 10.1186/s12886-024-03646-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/19/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND This study aimed to precisely predict the size and silicone oil injection of a foldable capsular vitreous body (FCVB) via computerized three-dimensional (3D) ocular reconstruction in the treatment of severe retinal detachment in China. METHODS The 3D software Unigraphics NX was applied to determine the volume of the inner cavity with 16-30 mm axial length, assigning the anterior and posterior chambers, the FCVB sizes, and the silicone oil injection volume, and modeling the data between the axial length and the FCVB size. In clinical practice, IOL Master was applied to accurately measure the axial length of the contralateral healthy eye to anchor the anterior-posterior and horizontal diameters of the operated eye in horizontal position CT, and compared with the model to recommend the FCVB size and silicone oil amount, and the clinical effect was validated in cases across five hospitals in China. RESULTS For the axial length of 16-30 mm, the volume of the inner cavity is 1.2 ml-8.4 ml. FCVB size and silicone oil volume were recommended based on this volume of the inner cavity. Of 253 cases, we noted 11 cases implanted with AV-10P and 1.05 ± 0.21 ml of silicone oil, 41 with AV-12P and 1.58 ± 0.18 ml of silicone oil, 163 with AV-13.5P and 2.48 ± 0.29 ml of silicone oil, 31 with AV-15P and 3.57 ± 0.39 ml of silicone oil, and 7 with AV-17P and 5.71 ± 0.81 ml of silicone oil. There was no significant difference in postoperative visual acuity scores compared with preoperative (P = 0.097), postoperative IOP(10.29 ± 0.57mmHg)was slightly higher than preoperative IOP (9.76 ± 0.48 mmHg), but there was still no statistically significant difference between the two comparisons (P = 0.405). CONCLUSION Three-dimensional reconstruction prediction is a good solution for eyeballs with obvious individualized changes in severe retinal detachment, and this method helps doctors standardize FCVB size selection and the silicone oil amount for patients.
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Affiliation(s)
- Chongde Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510060, China
| | - Qianying Gao
- Vesber Vitreous Institute, Guangzhou, 510060, China
| | | | - Yan Chen
- Xiamen Eye Center of Xiamen University, Xiamen, China
| | - Huping Song
- Xi'an People's Hospital (Xi'an Fourth Hospital), Xian, China
| | - Jinguo Yu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Bingsheng Lou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510060, China
| | - Zhaohui Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510060, China
| | - Yongxin Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510060, China
| | - Liuxueying Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510060, China
| | - Siqi Qiao
- Vesber Vitreous Institute, Guangzhou, 510060, China
| | - Xiangda Meng
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yuanyuan Liu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yingyu Wang
- Vesber Vitreous Institute, Guangzhou, 510060, China
| | - Yuanyuan Liu
- Vesber Vitreous Institute, Guangzhou, 510060, China
| | - Xiaofeng Lin
- Aier Ophthalmology Institute, Aier Mansion, No.188 South Furong Road, Changsha City, Hunan province, China.
| | - Hua Yan
- Tianjin Medical University General Hospital, Tianjin, China.
- Laboratory of Molecular Ophthalmology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
- Medical School of Nankai University, Tianjin, China.
- Department of Ophthalmology, Tianjin Medical University General Hospital Medical School of Nankai University, Tianjin, 300052, China.
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Qu S, Tang Y, Ning Z, Zhou Y, Wu H. Desired properties of polymeric hydrogel vitreous substitute. Biomed Pharmacother 2024; 172:116154. [PMID: 38306844 DOI: 10.1016/j.biopha.2024.116154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 02/04/2024] Open
Abstract
Vitreous replacement is a commonly employed method for treating a range of ocular diseases, including posterior vitreous detachment, complex retinal detachment, diabetic retinopathy, macular hole, and ocular trauma. Various clinical substitutes for vitreous include air, expandable gas, silicone oil, heavy silicone oil, and balanced salt solution. However, these substitutes have drawbacks such as short retention time, cytotoxicity, high intraocular pressure, and the formation of cataracts, rendering them unsuitable for long-term treatment. Polymeric hydrogels possess the potential to serve as ideal vitreous substitutes due to their structure-mimicking to natural vitreous and adjustable mechanical properties. Replacement with hydrogels as the tamponade can help maintain the shape of the eyeball, apply pressure to the detached retina, and ensure the metabolic transport of substances without impairing vision. This literature review examines the required properties of artificial vitreous, including the optical properties, rheological properties, expansive force action, and physiological and biochemical functions of chemically and physically crosslinked hydrogels. The strategies for enhancing the biocompatibility and injectability of hydrogels are also summarized and discussed. From a clinical ophthalmology perspective, this paper presents the latest developments in vitreous replacement, providing clinicians with a comprehensive understanding of hydrogel clinical applications, which offers guidance for future design directions and methodologies for hydrogel development.
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Affiliation(s)
- Sheng Qu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Yi Tang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Zichao Ning
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Yanjie Zhou
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Hong Wu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China.
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Li S, Wang X, Dou Z, Zhang J, Jia J. Study on maintenance of eyeball morphology by foldable capsular vitreous body in severe ocular trauma. BMC Ophthalmol 2023; 23:463. [PMID: 37974090 PMCID: PMC10655399 DOI: 10.1186/s12886-023-03209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES To explore the feasibility and safety of using a foldable capsular vitreous body (FCVB) in managing severe ocular trauma and silicone oil-dependent eyes. METHODOLOGY This is a retrospective study of 61 ocular trauma patients (61 eyes) who presented to the Department of Eye Emergency, Hebei Eye Hospital from May 1, 2018, to May 31, 2019, including 51 male patients (51 eyes) and 10 female patients (10 eyes) with an average age of 44.98 ± 14.60 years old. The oldest patient was 75 years old, and the youngest was 8 years old. These cases represented 51 eyes with severe eyeball rupture and 10 eyes with severe, complicated ocular trauma, which became silicone oil-dependent after the operation. These patients received FCVB implants, and data regarding their visual acuity, intraocular pressure, changes in eye axis, cornea, retina, and FCVB state were recorded after the operation. RESULTS In all patients, the FCVB was properly positioned and well supported with the retina. All 61 patients cleared a follow-up window of 1-36 months with no reports of important changes in their visual acuity. Among the patients, 91.8% reported normal intraocular pressure, the retinal reattachment rate reached 100%, and the eyeball atrophy control rate reached 100%. There was no report of rupture of the FCVB, allergies to silicone, intraocular infection, intraocular hemorrhage, silicone oil emulsification, or sympathetic ophthalmia. CONCLUSIONS Foldable capsular vitreous bodies (FCVBs) designed to mimic natural vitreous bodies are suitable as long-term ocular implants that can provide sustained support for the retina without the need for any special postoperative postures. Their barrier function may effectively prolong the retention time of the tamponade and prevent various complications caused by direct contact of the eye tissues with the tamponade.
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Affiliation(s)
- Shanyu Li
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China
| | - Xiaoxuan Wang
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China.
| | - Zhixia Dou
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China
| | - Jie Zhang
- Xingtai Third Hospital, 054000, Xingtai, Hebei, China
| | - Jinchen Jia
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China
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Abu Serhan H, Irshaidat S, Abu Serhan L, Elnahry AG. Foldable capsular vitreous body indications, complications, and outcomes: a systematic review. Graefes Arch Clin Exp Ophthalmol 2023; 261:2103-2116. [PMID: 36795160 DOI: 10.1007/s00417-023-05995-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/10/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE Foldable capsular vitreous body (FCVB) is an emerging vitreous substitute that has been recently introduced to treat various advanced vitreoretinal conditions including severe ocular trauma, complicated retinal detachment (RD), and proliferative vitreoretinopathy. METHODS Review protocol was prospectively registered at PROSPERO (CRD42022342310). A systematic literature search using PubMed, Ovid MEDLINE, and Google Scholar for articles published until May 2022 was performed. The search included the following keywords: foldable capsular vitreous body, FCVB, artificial vitreous substitutes, and artificial vitreous implants. Outcomes included indications of FCVB, anatomical success rates, postoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA), and complications. RESULTS A total of 17 studies that utilized FCVB up to May 2022 were included. FCVB was used intraocularly as a tamponade or extraocularly as a macular/scleral buckle for various retinal conditions including severe ocular trauma, simple and complex RD, silicone oil-dependent eyes, and highly myopic eyes with foveoschisis. FCVB was reported to be successfully implanted in the vitreous cavity of all patients. Final retinal reattachment rate ranged from 30 to 100%. Postoperative IOP improved or was maintained in most eyes, with low postoperative complication rates. Improvement in BCVA ranged from 0 to 100% of subjects. CONCLUSION Indications of FCVB implantation have recently widened to include multiple advanced ocular conditions such as complex RD, but also include simpler conditions as uncomplicated RD. FCVB implantation showed good visual and anatomical outcomes, few IOP fluctuations, and a good safety profile. Larger comparative studies are required to further evaluate FCVB implantation.
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Affiliation(s)
- Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporations, Doha, Qatar
| | - Sara Irshaidat
- Department of Pediatrics, King Hussein Cancer Centre, Amman, Jordan
| | | | - Ayman G Elnahry
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, 10 Center Dr, Room 10D45, Bethesda, MD, 20892-2510, USA.
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Naik K, Du Toit LC, Ally N, Choonara YE. Advances in Polysaccharide- and Synthetic Polymer-Based Vitreous Substitutes. Pharmaceutics 2023; 15:566. [PMID: 36839888 PMCID: PMC9961338 DOI: 10.3390/pharmaceutics15020566] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
The vitreous humour is a gel-like structure that composes the majority of each eye. It functions to provide passage of light, be a viscoelastic dampener, and hold the retina in place. Vitreous liquefaction causes retinal detachment and retinal tears requiring pars plana vitrectomy for vitreous substitution. An ideal vitreous substitute should display similar mechanical, chemical, and rheological properties to the natural vitreous. Currently used vitreous substitutes such as silicone oil, perfluorocarbon liquids, and gases cannot be used long-term due to adverse effects such as poor retention time, cytotoxicity, and cataract formation. Long-term, experimental vitreous substitutes composed of natural, modified and synthetic polymers are currently being studied. This review discusses current long- and short-term vitreous substitutes and the disadvantages of these that have highlighted the need for an ideal vitreous substitute. The review subsequently focuses specifically on currently used polysaccharide- and synthetic polymer-based vitreous substitutes, which may be modified or functionalised, or employed as the derivative, and discusses experimental vitreous substitutes in these classes. The advantages and challenges associated with the use of polymeric substitutes are discussed. Innovative approaches to vitreous substitution, namely a novel foldable capsular vitreous body, are presented, as well as future perspectives related to the advancement of this field.
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Affiliation(s)
- Kruti Naik
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Lisa C. Du Toit
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Naseer Ally
- Division of Ophthalmology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Yahya E. Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
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Confalonieri F, Josifovska N, Boix-Lemonche G, Stene-Johansen I, Bragadottir R, Lumi X, Petrovski G. Vitreous Substitutes from Bench to the Operating Room in a Translational Approach: Review and Future Endeavors in Vitreoretinal Surgery. Int J Mol Sci 2023; 24:3342. [PMID: 36834754 PMCID: PMC9961686 DOI: 10.3390/ijms24043342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Vitreous substitutes are indispensable tools in vitreoretinal surgery. The two crucial functions of these substitutes are their ability to displace intravitreal fluid from the retinal surface and to allow the retina to adhere to the retinal pigment epithelium. Today, vitreoretinal surgeons can choose among a plethora of vitreous tamponades, and the tamponade of choice might be difficult to determine in the ever-expanding range of possibilities for a favorable outcome. The currently available vitreous substitutes have disadvantages that need to be addressed to improve the surgical outcome achievable today. Herein, the fundamental physical and chemical proprieties of all vitreous substitutes are reported, and their use and clinical applications are described alongside some surgical techniques of intra-operative manipulation. The major upcoming developments in vitreous substitutes are extensively discussed, keeping a translational perspective throughout. Conclusions on future perspectives are derived through an in-depth analysis of what is lacking today in terms of desired outcomes and biomaterials technology.
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Affiliation(s)
- Filippo Confalonieri
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Natasha Josifovska
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Gerard Boix-Lemonche
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Ingar Stene-Johansen
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
| | - Ragnheidur Bragadottir
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Xhevat Lumi
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Eye Hospital, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia
| | - Goran Petrovski
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, 21000 Split, Croatia
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Ma S, Zhao S, Zhang C, Tang X, Zhou W. Study on the efficacy and safety of foldable capsular vitreous body in the severe retinal detachment eyes. BMC Ophthalmol 2022; 22:491. [PMID: 36522622 PMCID: PMC9756693 DOI: 10.1186/s12886-022-02729-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body (FCVB) in severe retinal detachment eyes. METHODS A retrospective study in retinal detachment eyes was performed at Shandong Provincial Hospital Affiliated to Shandong First Medical University. A standard three-port pars plana vitrectomy was performed, and the FCVB was triple folded and implanted into the vitreous cavity. The silicone oil (SO) was then injected into the capsule of the FCVB to support the retina and eye. During the follow-up period, The treated eyes were examined by ophthalmoscopy, fundus photography, and tonometry. B-scan ultrasonography, optical coherence tomography (OCT), and computed tomography (CT), were also performed. RESULTS From May 2020 to November 2021, 31 cases with severe retinal detachment were enrolled in the study. The postoperative follow-up time gradient ranged from 1 to 72 weeks, At various observation time points during the 72 weeks after surgery, The postoperative IOP was maintained at around 10 mmhg at various time points, with a slight decrease compared to the preoperative IOP (14.2 ± 4.6 mmHg n = 18), and was statistically significant. 9 of 31 patients had clear refractive media, both fundus and OCT showed retinal reattachment, OCT showed the 200 μm thick FCVB capsule support retina. The remaining 22 patients with unclear refractive media, B-scan showed arcuate hyperechoes in front of the retina. There was also no significant difference in visual acuity compared to preoperative. The FCVB was well positioned in the vitreous cavity, and no serious complications such as endophthalmitis, glaucoma, silicone oil emulsification, product exposure, or sympathetic uveitis were found. CONCLUSIONS FCVB has retinal support with certain ability to maintain IOP and eye morphology and avoid eye removal in patients with severe retinal detachment during the 72-week observation period.
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Affiliation(s)
- Shengnan Ma
- grid.460018.b0000 0004 1769 9639Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000 Shandong Province China
| | - Suzhen Zhao
- grid.460018.b0000 0004 1769 9639Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000 Shandong Province China
| | - Chunxiao Zhang
- grid.460018.b0000 0004 1769 9639Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000 Shandong Province China
| | - Xia Tang
- grid.460018.b0000 0004 1769 9639Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000 Shandong Province China
| | - Weiyan Zhou
- grid.460018.b0000 0004 1769 9639Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000 Shandong Province China
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Clinical Application of Foldable Capsular Vitreous Bodies in the Treatment of Severe Ocular Trauma and Silicone Oil Dependent Eyes. J Ophthalmol 2022; 2022:3608162. [PMID: 36339727 PMCID: PMC9635962 DOI: 10.1155/2022/3608162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/18/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes. Methods A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results Seven eyes of seven patients were included in the 6-month follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean ± SD IOP was 8.5 ± 1.90 mm·Hg prior to FCVB implantation and 10.43 ± 0.98 mm·Hg after implantation, with no significant difference between these measurements (P=0.095). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, FCVB cannot prevent the phthisis of the traumatic eyes. In addition, corneal opacity and keratopathy are potentially serious complications after surgery. Appropriate case selection and proper surgical timing are required for further investigation.
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Chen S, Tian M, Zhang L, Hu C, Liu K, Qin B, Liu S. Reattachment After Foldable Capsular Vitreous Body Implantation in Severe Retinal Detachment Eyes. Transl Vis Sci Technol 2021; 10:8. [PMID: 34491287 PMCID: PMC8431979 DOI: 10.1167/tvst.10.11.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the clinical effectiveness and safety of foldable capsular vitreous body (FCVB) implantation for severe retinal detachment. Methods A retrospective analysis was performed on 26 patients with severe ocular trauma and one with recurrent retinal detachment. Clinical data-including surgery success, complications, retinal reattachment, vision, and intraocular pressure (IOP)-were analyzed for patients who underwent 23G pars plana vitrectomy and FCVB implantation combined with silicone oil tamponade. Results The mean follow-up period was 10.44 ± 2.68 months. All surgeries were smooth; the FCVBs were properly positioned and supported the retina well, and the retinal reattachment rate reached 92.59%. At the six-month follow-up, preoperative (1.30 ± 1.20) and postoperative (0.63 ± 0.79) vision was significantly different (t = 3.03, P = 0.005), and the postoperative IOP (7.93 ± 3.57 mm Hg) was lower than the preoperative IOP (13.98 ± 10.72 mm Hg) (t = 2.74, P = 0.01). Among 20 patients followed up for >12 months, preoperative (1.20 ± 0.95) and postoperative (0.75 ± 0.91) visions were significantly different (t = 1.831, P = 0.005), and the postoperative IOP (9.85 ± 6.48 mm Hg) was lower than the preoperative IOP (14.85 ± 12.17 mm Hg) (t = 1.82, P = 0.01). No endophthalmitis, sympathetic ophthalmia, and rejection of FCVB occurred during follow-up. Conclusions FCVB combined with silicone oil tamponade showed good efficacy and safety in severe retinal detachment treatment during the follow-up period. Translational Relevance Vitreous substitution is deemed a highly challenging and interesting research topic in ophthalmology. Traditional method such as silicone oil tamponade often causes various complications such as silicone oil emulsification, silicone oil migration, and corneal degeneration. The foldable capsular vitreous body as a novel vitreous substitute combined silicone oil injection into it can stay in the eyeball for a long time without obvious complications.
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Affiliation(s)
- Sheng Chen
- Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, Guangdong province, China
| | - Meiwen Tian
- Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, Guangdong province, China.,Second Clinical College of Jinan University, Shenzhen, Guangdong Province, China
| | - Liang Zhang
- Shenzhen Aier Eye Hospital, Shenzhen, Guangdong Province, China
| | - Chenli Hu
- Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, Guangdong province, China
| | - Ke Liu
- Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, Guangdong province, China
| | - Bo Qin
- Shenzhen Aier Eye Hospital, Shenzhen, Guangdong Province, China
| | - Shenwen Liu
- Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, Guangdong province, China
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Zeng B, Wang Q, Sui G, Wang M, Xie W, Fu J. Foldable capsular vitreous body implantation for treatment of traumatic retinal detachment: two case reports. J Int Med Res 2021; 49:300060521990257. [PMID: 33563057 PMCID: PMC7879493 DOI: 10.1177/0300060521990257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Retinal detachment caused by severe ocular trauma is a type of refractory vitreoretinal disease. Current treatment methods include vitrectomy combined with silicone oil tamponade. However, long-term use of silicone oil tamponade has various complications, including a risk of silicone oil dependence that eventually leads to eyeball atrophy and enucleation. Foldable capsular vitreous bodies (FCVBs) offer a good solution for these problems. However, FCVBs have not been used in large-scale clinical applications and few cases have been reported in the published literature. The main use of FCVBs, based on current evidence, is in the treatment of the relatively few (but important) patients whose eyes have no visual potential; the aim of treatment in these patients is globe preservation, rather than restoration of vision. Here, we describe two patients who underwent FCVB implantation. The findings in these patients indicated that FCVBs can effectively support the vitreous cavity and detached retina. FCVB implantation may thus offer a safe and effective method for treatment of severe retinal detachment, avoiding the inconvenience caused by silicone oil dependence and enucleation. To confirm its long-term usefulness in clinical applications, many additional case reports are needed.
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Affiliation(s)
- Baihui Zeng
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Qian Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Guiqin Sui
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Mingxuan Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Wei Xie
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Jinling Fu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
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11
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Zhang L, Liu J, Liu S, Qin B. Implantation of Foldable Capsular Vitreous Body for the Treatment of Acute Retinal Necrosis Syndrome: A Case Report. Ophthalmic Surg Lasers Imaging Retina 2020; 51:653-657. [PMID: 33231700 DOI: 10.3928/23258160-20201104-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/03/2020] [Indexed: 11/20/2022]
Abstract
The authors present the case of a 35-year-old male who was diagnosed with acute retinal necrosis syndrome that evolved into retinal detachment (RD), even after immediate treatment with systemic antiviral medications, as well as intravitreal injection and laser photocoagulation. Pars plana vitrectomy plus silicone oil tamponade was performed, but silicone oil emulsified 22 months later. Due to the widespread necrosis lesions and defects of the peripheral retina, RD was highly likely to reoccur after silicone oil removal; thus, foldable capsular vitreous body was implanted to support the retina. No recurrent RD was observed afterward. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:653-657.].
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Tram NK, Maxwell CJ, Swindle-Reilly KE. Macro- and Microscale Properties of the Vitreous Humor to Inform Substitute Design and Intravitreal Biotransport. Curr Eye Res 2020; 46:429-444. [PMID: 33040616 DOI: 10.1080/02713683.2020.1826977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Research on the vitreous humor and development of hydrogel vitreous substitutes have gained a rapid increase in interest within the past two decades. However, the properties of the vitreous humor and vitreous substitutes have yet to be consolidated. In this paper, the mechanical properties of the vitreous humor and hydrogel vitreous substitutes were systematically reviewed. The number of publications on the vitreous humor and vitreous substitutes over the years, as well as their respective testing conditions and testing techniques were analyzed. The mechanical properties of the human vitreous were found to be most similar to the vitreous of pigs and rabbits. The storage and loss moduli of the hydrogel vitreous substitutes developed were found to be orders of magnitude higher in comparison to the native human vitreous. However, the reported modulus for human vitreous, which was most commonly tested in vitro, has been hypothesized to be different in vivo. Future studies should focus on testing the mechanical properties of the vitreous in situ or in vivo. In addition to its mechanical properties, the vitreous humor has other biotransport mechanisms and biochemical functions that establish a redox balance and maintain an oxygen gradient inside the vitreous chamber to protect intraocular tissues from oxidative damage. Biomimetic hydrogel vitreous substitutes have the potential to provide ophthalmologists with additional avenues for treating and controlling vitreoretinal diseases while preventing complications after vitrectomy. Due to the proximity and interconnectedness of the vitreous humor to other ocular tissues, particularly the lens and the retina, more interest has been placed on understanding the properties of the vitreous humor in recent years. A better understanding of the properties of the vitreous humor will aid in improving the design of biomimetic vitreous substitutes and enhancing intravitreal biotransport.
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Affiliation(s)
- Nguyen K Tram
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Courtney J Maxwell
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Katelyn E Swindle-Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.,William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.,Department of Ophthalmology & Visual Science, The Ohio State University, Columbus, OH, USA
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13
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Macoon R, Robey M, Chauhan A. In vitro release of hydrophobic drugs by oleogel rods with biocompatible gelators. Eur J Pharm Sci 2020; 152:105413. [DOI: 10.1016/j.ejps.2020.105413] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/08/2020] [Accepted: 06/04/2020] [Indexed: 12/26/2022]
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Zhang X, Tian X, Zhang B, Guo L, Li X, Jia Y. Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation. BMC Ophthalmol 2019; 19:260. [PMID: 31852464 PMCID: PMC6921415 DOI: 10.1186/s12886-019-1268-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/06/2019] [Indexed: 12/13/2022] Open
Abstract
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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Affiliation(s)
- Xiangyang Zhang
- Xinxiang Medical University, Xinxiang, 453003, Henan Province, China.,The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Xuemin Tian
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China.
| | - Baike Zhang
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Lisa Guo
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Xiaodan Li
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Yong Jia
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
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15
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Risk Factors for Trauma-Related Eviscerations: Analysis of 821 Cases. J Ophthalmol 2019; 2019:6198368. [PMID: 31827911 PMCID: PMC6881570 DOI: 10.1155/2019/6198368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/06/2019] [Accepted: 10/23/2019] [Indexed: 11/29/2022] Open
Abstract
Evisceration is the end therapeutic approach for the treatment of severe ocular trauma cases, and it is a tremendous loss for patients. In this study, we explored the changing trends in the number of surgeries performed, demographic data and ocular features, and risks for early evisceration, aiming to provide more data for the additional prevention and management strategies for this catastrophic problem. This was a retrospective study that included patients who underwent ocular evisceration at the Zhongshan Ophthalmic Center between January 2013 and December 2017. A total of 1229 evisceration cases were reviewed, and only trauma-related eviscerations were analyzed. Etiology, demographic data, ocular features, and hospitalization time were evaluated. The total number of trauma-related eviscerations recorded in the past five years was 821 cases. The number of surgeries performed was almost constant each year (164 ± 17 cases); 35% of the patients were less than ten years old at the time of the original ocular injury and 69% of them were male. Endophthalmitis led to significantly early evisceration compared with cases without endophthalmitis (P < 0.05). The group with a history of silicone oil tamponade showed a significantly longer surgical interval between trauma and evisceration than did the nonsilicone oil tamponade group (P < 0.05). Day-case hospitalization for evisceration increased from 0% to 32% over the past five years. The results of the present study show that the number of ocular trauma-related eviscerations performed in the past five years was almost unchanged and boys under ten are highly susceptible. This study also demonstrates that endophthalmitis leads to significantly early evisceration, and silicone oil tamponade may postpone ocular atrophy. Based on the study data, day-case surgery is safe for evisceration management.
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Macoon R, Guerriero T, Chauhan A. Extended release of dexamethasone from oleogel based rods. J Colloid Interface Sci 2019; 555:331-341. [PMID: 31394320 PMCID: PMC6764860 DOI: 10.1016/j.jcis.2019.07.082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/26/2019] [Accepted: 07/27/2019] [Indexed: 12/18/2022]
Abstract
HYPOTHESIS Topical and systemic methods are not able to deliver ophthalmic drugs for treatment of retinal diseases. Consequently, invasive monthly intravitreal injections through the eyeball are required to deliver retinal drugs. A reduction in the frequency of the injection through extended release of the drugs could have significant clinical benefits. EXPERIMENTS Oleogels containing ethyl cellulose as the gelator at 10% (wt%) in soybean oil were loaded with dexamethasone above the solubility limit and expunged from a syringe to create cylindrical rods for extended drug delivery. The devices were imaged to explore particle distribution and drug release was measured under sink conditions in buffer. A model was developed and fitted to data to determine effective drug diffusivity. FINDINGS Dexamethasone is released slowly due to the presence of the drug particles that serve as drug depots. The release increases from 600 to 3000 h as the drug loading is increased from 3% to 28%. The release profiles can be modeled by considering drug dissolution and diffusion, as well as the tortuosity of the matrix due to the presence of the voids formed after the drug particles have dissolved. The proposed approach is promising as the release profiles of the drug are comparable to commercial devices.
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Affiliation(s)
- Russell Macoon
- Department of Chemical Engineering, University of Florida, Gainesville, FL 32611, United States.
| | - Timothy Guerriero
- Department of Chemical Engineering, University of Florida, Gainesville, FL 32611, United States.
| | - Anuj Chauhan
- Department of Chemical Engineering, Colorado School of Mines, Golden, CO 80401, United States.
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Gao QY, Fu Y, Hui YN. Vitreous substitutes: challenges and directions. Int J Ophthalmol 2015; 8:437-40. [PMID: 26085987 DOI: 10.3980/j.issn.2222-3959.2015.03.01] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 02/10/2014] [Indexed: 01/07/2023] Open
Abstract
The natural vitreous body has a fine structure and complex functions. The imitation of the natural vitreous body by vitreous substitutes is a challenging work for both researchers and ophthalmologists. Gases, silicone oil, heavy silicone oil and hydrogels, particularly the former two vitreous substitutes are clinically widely used with certain complications. Those, however, are not real artificial vitreous due to lack of structure and function like the natural vitreous body. This article reviews the situations, challenges, and future directions in the development of vitreous substitutes, particularly the experimental and clinical use of a new artificial foldable capsular vitreous body.
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Affiliation(s)
- Qian-Ying Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yue Fu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yan-Nian Hui
- Department of Ophthalmology, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
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Yang W, Yuan Y, Zong Y, Huang Z, Mai S, Li Y, Qian X, Liu Y, Gao Q. Preliminary study on retinal vascular and oxygen-related changes after long-term silicone oil and foldable capsular vitreous body tamponade. Sci Rep 2014; 4:5272. [PMID: 24920425 PMCID: PMC4053724 DOI: 10.1038/srep05272] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/23/2014] [Indexed: 12/27/2022] Open
Abstract
Silicone oil has been the only long-term vitreous substitute used in the treatment of retinal detachment since 1962 by Cibis. Nevertheless, its effects on retinal vascular morphology and oxygen supply to the retina are ambiguous in current research. We previously invented a foldable capsular vitreous body (FCVB) to use as a new vitreous substitute in the treatment of severe retinal detachment, but its effects on the retinal vessel were unknown. Therefore, in this study, a standard three-port pars plana vitrectomy (PPV) was performed on the right eye of each rabbit and then silicone oil and FCVB were injected into the vitreous cavity as vitreous substitutes. After 180 days of retention, the retinal vascular morphology did not display any distinct abnormalities, and hypoxia-induced factor-1alpha (HIF-1α) and vascular endothelial growth factor (VEGF) did not vary markedly during the observation period in silicone oil tamponade- and FCVB-implanted eyes. This study may suggest that silicone oil and FCVB tamponade in rabbit eyes did not cause retinal vascular pathologic changes or retinal hypoxia for 180 days.
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Affiliation(s)
- Wei Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Yongguang Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Yao Zong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Zhen Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Shuyi Mai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Yujie Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiaobing Qian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Yaqin Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Qianying Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
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Huang Z, Yang W, Zong Y, Qiu S, Chen X, Sun X, Zhou Y, Xie Z, Gao Q. A study of the dexamethasone sodium phosphate release properties from a periocular capsular drug delivery system. Drug Deliv 2014; 23:849-57. [PMID: 24865291 DOI: 10.3109/10717544.2014.919543] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to investigate whether a periocular capsular drug delivery system (DDS) can release dexamethasone sodium phosphate (DEXP) in vitro and in vivo to the posterior segment of rabbit's eye. In vitro, the periocular capsular DDS containing 2 mg/ml or 5 mg/ml DEXP was immersed in modified Franz diffusion cell. Four-hundred microliters of liquid was aspirated at 0.5, 1, 2, 4, 8, 24 and 48 h for determination. In vivo, the DEXP-filled periocular capsular DDS was implanted into the sub-Tenon's sac of the New Zealand rabbit. DEXP concentration at the serum aqueous humor, cornea, iris, lens, ciliary body, vitreous, retina, choroids and sclera was quantified at 1, 3, 7, 14, 28 and 56 d after implantation. The DEXP concentration was determined by ultra-performance liquid chromatography-tandem mass spectrometry. In vitro, the periocular capsular DDS released the DEXP in time-dependent manner from 1/2 to 48 h. In vivo, the concentrations of the DEXP at the retina, choroids, ciliary body and iris were 123.11 (91.23, 732.61) ng/g, 362.46 ± 330.46 ng/g, 71.64 (71.35, 180.21) ng/g and 192.50 ± 42.66 ng/g, respectively, at 56 d after implantation. Minimal DEXP was found in the aqueous, serum and vitreous. Our results demonstrated that DEXP could be sustained released from the periocular capsular DDS, which indicated that the periocular capsular DDS might be a potential candidate of transscleral drug delivery for the management of posterior segment diseases.
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Affiliation(s)
- Zhen Huang
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
| | - Wei Yang
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
| | - Yao Zong
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
| | - Suo Qiu
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
| | - Xiaoqing Chen
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
| | - Xuyuan Sun
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
| | - Yuting Zhou
- b Laboratory of Pharmaceutical Analysis and Quality Assessment , School of Pharmaceutical Sciences, Sun Yat-sen University , Guangzhou , People's Republic of China
| | - Zhiyong Xie
- b Laboratory of Pharmaceutical Analysis and Quality Assessment , School of Pharmaceutical Sciences, Sun Yat-sen University , Guangzhou , People's Republic of China
| | - Qianying Gao
- a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , People's Republic of China and
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Feng S, Chen H, Liu Y, Huang Z, Sun X, Zhou L, Lu X, Gao Q. A novel vitreous substitute of using a foldable capsular vitreous body injected with polyvinylalcohol hydrogel. Sci Rep 2013; 3:1838. [PMID: 23670585 PMCID: PMC3653144 DOI: 10.1038/srep01838] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/30/2013] [Indexed: 01/18/2023] Open
Abstract
Hydrogels may be the ideal vitreous substitutes due to their wonderful physical features and biocompatibility. However, their drawbacks, short residence time, and biodegradation in vivo, have led to the fact that none of them have been approved for clinical use. In this study, we developed a novel approach of using a foldable capsular vitreous body (FCVB) injected with polyvinylalcohol (PVA) hydrogel as a vitreous substitute for long-term tamponade. The 3% PVA hydrogel that was cross-linked by gamma irradiation showed good rheological and physical properties and had no toxicity in vitro. After 180 days retention, the 3% PVA hydrogel inside FCVB remained transparent and showed good viscoelasticity without biodegradation and showed good biocompatibility and retina support. This new approach may develop into a valuable tool to improve the stability performance of PVA hydrogel as a vitreous substitute and to extend the application function of FCVB for long-term implantation in vitreous cavity.
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Affiliation(s)
- Songfu Feng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, China
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Chen H, Feng S, Liu Y, Huang Z, Sun X, Zhou L, Lu X, Gao Q. Functional evaluation of a novel vitreous substitute using polyethylene glycol sols injected into a foldable capsular vitreous body. J Biomed Mater Res A 2013; 101:2538-47. [PMID: 23359564 DOI: 10.1002/jbm.a.34560] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 12/12/2012] [Indexed: 01/18/2023]
Affiliation(s)
| | | | - Yaqin Liu
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-sen University; Guangzhou 510060; People's Republic of China
| | - Zhen Huang
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-sen University; Guangzhou 510060; People's Republic of China
| | - Xuyuan Sun
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-sen University; Guangzhou 510060; People's Republic of China
| | - Lian Zhou
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-sen University; Guangzhou 510060; People's Republic of China
| | - Xiaohe Lu
- Department of Ophthalmology; Zhujiang Hospital, Southern Medical University; Guangzhou 515282; People's Republic of China
| | - Qianying Gao
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-sen University; Guangzhou 510060; People's Republic of China
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