AI Summary & Key Takeaways
AI InsightMean energy levels for achieving patent iridotomies in eyes with and without SH were 145.5±29.8 mJ, and 115.5±39.8 mJ, respectively (p=0.240). conclusion: It was concluded that, intracameral sodium hyaluronate injection in rabbits before Nd:YAG laser iridotomy might be protective in terms of corneal endothelial damage, particularly in the presence of narrow anterior chambers.
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Abstract
Purpose: To investigate the effectiveness of intracameral sodium hyaluronate (SH) injection before Nd:YAG laser iridotomy in preventing corneal endothelial damage. Material and Methods: Twelve rabbits which have been sacrificed at the end of an extraocular experimental study were transferred to our clinic within an hour of extermination. Among 6 pigmented rabbits, anterior chambers were left normal in three (Group 1), and 0.1 ml aqueous humor were aspirated from the anterior chambers in the remaining three (Group 2), thereafter bilateral 10 iridotomy shots were performed with Nd:YAG laser in each rabbit. Additionally, 0.1 ml of aqueous was replaced with 0.1 ml of SH (Healon, 1%) in the left eyes of all six pigmented rabbits before the laser procedures. Laser energy levels for each shot were determined as 3, 6, and 9 mJ in consecutive 3 rabbits in both groups. In 6 albino rabbits anterior chambers were narrowed bilaterally by aspiration of 0.1 ml of aqueous in both eyes. In addition, 0.1 ml of aqueous was replaced with 0.1 ml of SH (Healon, 1%) in the left eyes of all six albino rabbits and laser applications were performed with a fixed energy level of 9 mJ in all eyes until a patent iridotomy was achieved. All eyes were enucleated and fixated in order to evaluate the extent of corneal endothelial damage in sections obtained from the assigned iridotomy quadrants. Results: In Group 1 of pigmented rabbits, endothelial damage was detected at laser energy levels higher than 3 mJ in eyes without SH, and at levels higher than 6 mJ in eyes in which intracameral SH was injected. In Group 2, endothelial damage was demonstrated with 3 mJ in eyes without SH, and with 6 mJ in eyes with intracameral SH. In albino rabbits rate of endothelial damage was 2/6 in SH injected left eyes, and was 4/6 in eyes without SH (p=0.284). Mean energy levels for achieving patent iridotomies in eyes with and without SH were 145.5±29.8 mJ, and 115.5±39.8 mJ, respectively (p=0.240). conclusion: It was concluded that, intracameral sodium hyaluronate injection in rabbits before Nd:YAG laser iridotomy might be protective in terms of corneal endothelial damage, particularly in the presence of narrow anterior chambers.
Özet
Amaç: Tavşanlarda Nd:YAG lazer iridotomi öncesinde ön kamaraya sodyum hiyaluronat (SH) enjeksiyonunun kornea endotel hasarının önlenmesindeki etkinliğinin araştırılması. Gereç ve Yöntem: Göz dışı deneysel bir çalışma sonrasında yaşamları sonlandırılan 12 tavşan, 1 saat içinde kliniğimize nakledildiler. Altı pigmente tavşandan üçünde ön kamara daraltılmaksızın (Grup 1), üçünde ise ön kamaradan 0.1 ml aköz hümör aspire edilmesini takiben (Grup 2), Nd:YAG lazer ile her iki gözde 10’ar adet iridotomi atışı yapıldı. İşlem öncesinde her tavşanın sol gözüne ek olarak 0.1 ml aköz alınarak yerine aynı miktarda SH (%1, Healon) verildi. Lazer atım şiddeti her iki gruptaki 3 ayrı tavşanda sırasıyla 3, 6 ve 9 mJ olacak şekilde belirlendi. Altı albino tavşanda ise her iki gözde ön kamaralar 0.1 ml aköz boşaltılarak daraltıldı. Tavşanların sol gözlerinde ek olarak 0.1 ml aköz boşaltılarak yerine aynı miktarda SH verildi ve bilateral sabit 9 mJ enerji ile patent iridotomi elde edilene dek atış yapıldı. Tüm gözler enüklee ve fikse edildikten sonra iridotomi yapılan kadranlardan alınan kesitlerde mikroskobik olarak kornea endotel hasarı değerlendirildi. Bulgular: Pigmente tavşanlarda Grup 1’de endotel hasarı SH verilmeyen gözlerde 3 mJ, verilen gözlerde 6 mJ’ün üzerindeki değerlerde izlendi. Grup 2’de endotel hasarının SH verilmeyen gözlerde 3 mJ’de, verilen gözlerde ise 6 mJ’de başladığı görüldü. Albino tavşanlarda SH verilen gözlerde 2/6 (33%), verilmeyenlerde 4/6 (%67) oranında endotel hasarı izlendi (p=0.284). Albino grupta iridotomi için gereken ortalama enerji SH verilen gözlerde 145.5±29.8 mJ, verilmeyen gözlerde 115.5±39.8 mJ idi. (p=0.240). Sonuç: Tavşanlarda Nd:YAG lazer öncesi ön kamaraya sodyum hiyaluronat enjeksiyonunun, özellikle dar ön kamara varlığında, endotel hasarı açısından koruyucu olabileceği sonucuna varıldı.