A new and effective protective agent for intraocular lens insertion.

Area of Science:

• Ophthalmology
• Biomaterials Science
• Corneal Surgery

Background:

• Corneal endothelium damage during intraocular lens (IOL) implantation is a significant clinical concern.
• Protective coatings are essential to mitigate surgical trauma to the delicate corneal endothelium.
• Existing protective agents require further evaluation for efficacy and safety.

Purpose of the Study:

• To evaluate the protective efficacy of chondroitin sulfate (CDS) as a coating for IOLs during implantation.
• To compare CDS with other potential coatings like albumin and hyaluronic acid.
• To assess the safety and clearance profile of CDS in the anterior chamber.

Main Methods:

• In vitro and in vivo testing using acid violet 49 vital stain on approximately 600 animal corneas (rabbit, pig, cow, dog, cat, monkey).
• Simulated IOL implantation with variously coated lenses applied to corneal endothelium.
• Traumatic IOL insertion in rabbit and monkey models.
• Comparison with commercially available Healon and assessment of postoperative intraocular pressure.

Main Results:

• Chondroitin sulfate demonstrated superior protective qualities, surpassing albumin and hyaluronic acid.
• Albumin and hyaluronic acid coatings resulted in substantial endothelial damage.
• CDS provided total protection, outperforming even commercial Healon.
• CDS was cleared from the anterior chamber within 40 hours with no adverse effects on intraocular pressure.

Conclusions:

• Chondroitin sulfate is a highly efficacious protective agent for the corneal endothelium during IOL implantation.
• CDS offers superior protection compared to albumin, hyaluronic acid, and Healon.
• The rapid clearance and normal intraocular pressure profiles indicate a favorable safety profile for CDS.