Viscoat viscoelastic combined with soft corneal contact lens for central corneal perforation / 眼科新进展

Objective To investigate the clinical effects of the Viscoat viscoelastic combined with soft corneal contact lens for central corneal perforation.Methods Six cases were collected and treated with corneal local debridement of which diameter were less than 2.0 mm.Six cases received Viscoat viscoelastic injection into their anterior chamber.And then soft corneal contact lens were worn.The curative effect indicators such as patients' symptom,visual acuity,slit lamp examination,intraocular pressure,confocal microscope and corneal endothelial cell counts were recorded in the follow-up periods.Results All the cases were healed with the recovery time of 1 month to 2 months;After treatment,the best corrected visual acuity of patients were increased to 0.6-0.8 and average corneal endothelial cell count was (3415.5 ±279.5)mm-2.No obvious scar was left in the cornea and no serious complicatious occurred during treatment.Conclusion For traumatic corneal central perforation with diameter is 2.0 mm or less can be treated with Viscoat viscoelastic combined with soft corneal contact lens.This therapy is worthy of popularize since it's satisfied prognosis and less economic burden.

The Combined Effect of Physical Barriers and 5-Fluorouracil on Delayed Adjustable Strabismus Surgery

In order to prevent the formation of postoperative adhesions and delay the time of adjustment, the authors tried 5-fluorouracil and physical barriers of polytetrafluoroethylene, Interceed, Viscoat in rabbits. Fluorouracil delayed the adjustment for up to one week after surgery in three out of four eyes. Combined use of Interceed and 5-fluorouracil of addition of Viscoat could delay the adjustment for up to two weeks after surgery I one out of four eyes. Combined use of pophtetrafluoroethylene and 5-fluorouracil of addition of Viscoat could delay the adjustment for up to four weeks after surgery in four out of five eyes. In conclusion, combined use of polytetrafluoroethylene, 5-fluorouracil and Viscoat could be more helpful for delayine adjustment in rabbits.

The changes of Corneal Endothelial Morphology after Phacoemulsification by using Healon GV of Viscoat

Corneal endothelial cell damage from phacoemulsification has been attributed to mechanical injury caused by surgical manipulation and oxygen free radicals produced by ultrasound. We evaluated role of protective effect in Healon GV and Viscoat on corneal endothelial cell damage during phacoemulsificatin Seventy five eyes underwent phacoemulsigication hrough scleral tunnel incision with posterior chamber lens implantation.: Healon GV, 32 eyes and Viscoat, 43 eyes. We analyzed the corneal endothelial morphology using non-contact specualr microscope and analysis program.The percent loss of corneal endothelial density at 3 months postoperative period was greater in Viscoat(5.87%) than in Healon GV(2.47%),although it was not statistically significant(p>0.1). Coefficient of variation in cell size and hexagonality of the corneal endothelial cells also showed no significant difference between the two groups(p>0.1). In conclusion, Healon GV and Viscoat have similar protective effect on the corneal endothelial cell damage induced by ultrasound during phacoemulsification.

Use of Physical Barriers for the Surgical Treatment of Fat Adherence Syndrome: The Effect of Viscoat, Interceed, Polyglactin 910 Mesh and Polytetrafluoroethylene

The fat adherence syndrome is a type of restrictive strabismus resulting from the formation of adherence of orbital tissues to the globe or extraocular muscles in association with violation of Tenon`s capsule. The treatment of fat adherence syndrome has been extremely difficult. In order to determine the efficacy to prevent the development of restrictive scar tissue, the authors created adhesion of inferior rectus muscle to inferior orbital rim in 40 eyes of 20 rabbits. This was followed by placement of normal saline in control group, and Viscoat, Interceed(TC7), polyglactin 910 mesh and polytetrafluoroethylene(PTFE) in experimental groups as physical barriers between the inferior rectus muscle and hole of Tenon`s capsule. Forced ductions were performed 4 weeks postoperatively and histologic examinations were performed. Viscoat made less adhesion, although no difference was noted in terms of length and force for duction. Polyglactin 910 mesh failed to make less adhesion and any difference in length and force for duction. Interceed caused less force for duction, but no difference in the degree of adhesion and the length for duction. Polytetrafluoroethylene(PTFE) did prevent the formation of adhesion between the body of PTFE and the muscle, however the fibrous membrane formed at the edge of PTFE prevented the eye movement. Thus there was no difference in terms of length and force for duction as well as the degree of adhesion in PTFE group. In conclusion, these results may be helpful for studying the management of fat adherence syndrome.

The Effect of Physical Barriers on Delayed Adjustable Strabismus Surgery

Delayed reattachment of the muscle to the sclera may be desirable to correct the angle of deviation developed after the surgery of strabismus. In order to know the possible time for the delayed adjustment, the authors tried Viscoat(R). Interceed(TC7) and polyglactin 910 mesh(Vicryl mesh(R)) as physical barriers for preventing the formation of postoperative adhesions. These materials were placed around between the detached end of the muscle and the sclera in 29 rabbits and adjustment was performed thereafter. Viscoat(R) was effective in delaying the adjustment up to 6 days after surgery. Interceed(TC7) and polyglactin 910 mesh were effective in delaying the adjustment up to 1 week after surgery.