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Hydroxypropylmethylcellulose and sodium hyaluronate in adjustable strabismus surgery
R C Ferreira1, M Lamberts, J B Moreira
1Department of Ophthalmology, Paulista School of Medicine, Sao Paulo, Brazil.
Journal of Pediatric Ophthalmology and Strabismus
|July 1, 1995
Summary
Hydroxypropylmethylcellulose (HPMC) and sodium hyaluronate (Healon) effectively reduced the force needed for adjustable strabismus surgery adjustments in rabbits. Both viscoelastic agents performed similarly, with no significant difference in inflammation observed.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Biomaterials Science
Background:
- Adjustable strabismus surgery allows for intraoperative adjustments to correct eye alignment.
- Viscoelastic substances are sometimes used to maintain surgical space and protect tissues during ophthalmic procedures.
- The specific benefits of hydroxypropylmethylcellulose (HPMC) and sodium hyaluronate (Healon) as adjuncts in adjustable strabismus surgery require further investigation.
Purpose of the Study:
- To experimentally evaluate the efficacy of HPMC and sodium hyaluronate as adjuncts during adjustable strabismus surgery.
- To compare the effects of HPMC and sodium hyaluronate on the force required for muscle adjustment post-surgery.
- To assess the inflammatory response associated with the use of these viscoelastic agents.
Main Methods:
- The study utilized a randomized experimental design in NZA rabbits.
- Bilateral superior rectus muscle recession was performed, followed by submuscular injection of HPMC or Healon in experimental eyes, with a control group receiving no injection.
- Surgical outcomes were measured by the force required for muscle repositioning using a force gauge, with histological analysis for inflammation.
Main Results:
- A significant increase in the force needed for muscle adjustment was observed in all groups (control, Healon, HPMC) post-surgery (p < 0.001).
- Both Healon and HPMC groups demonstrated significantly less force required for adjustment compared to controls.
- No statistically significant difference was found in the efficacy or inflammatory response between HPMC and Healon.
Conclusions:
- Both hydroxypropylmethylcellulose and sodium hyaluronate serve as effective adjuncts in adjustable strabismus surgery by facilitating muscle repositioning.
- The choice between HPMC and Healon does not appear to impact surgical adjustability or local inflammation.
- These viscoelastic agents may enhance the outcomes of adjustable strabismus procedures by improving intraoperative muscle manipulation.