Efficacy of two different thiol-modified crosslinked hyaluronate formulations as vitreous replacement compared to silicone oil in a model of retinal detachment

PLoS One. 2017 Mar 1;12(3):e0172895. doi: 10.1371/journal.pone.0172895. eCollection 2017.

Abstract

The efficacy of two novel artificial vitreous body substitutes (VBS) consisting of highly biocompatible thiolated cross-linked hyaluronic acid (HA)-based hydrogels in comparison to silicone oil in a model of retinal detachment was investigated. Pars plana vitrectomy (23G) was performed in the right eye of 24 pigmented rabbits. Retinal detachment of two quadrants was induced by creating a small retinotomy near the vascular arcade and injecting balanced salt solution (BSS) subretinally. The retina was reattached by injecting air, which was followed by increasing the infusion pressure, and the retinal tear was treated by endolaser photocoagulation. At the end of the procedure, the eye was filled either with 5000-cs silicone oil (after fluid air exchange) or the respective hydrogel (with two different viscosities). Follow-up examination included slit lamp examination, funduscopy, intraocular pressure measurements (IOP), optical coherence tomography (OCT) and electroretinogram (ERG) measurements. After a maximum follow-up of four weeks both eyes were removed, examined macroscopically, photographed, and prepared for histology. Of the eight rabbits that received silicone oil, seven (87.5%) developed a recurrent retinal detachment with pronounced proliferative vitreoretinopathy within the first two weeks after surgery. In contrast, in the hydrogel treated eyes, the retina stayed attached in the majority of the cases (73.3%). IOP and retinal morphology were normal as long as the retina remained re-attached. In conclusions, this model of retinal detachment, both thiolated crosslinked hyaluronate hydrogels showed superior efficacy when compared to silicone oil. These hydrogels have a promising potential as novel vitreous body substitutes.

MeSH terms

  • Animals
  • Biocompatible Materials / adverse effects
  • Biocompatible Materials / chemistry
  • Biocompatible Materials / therapeutic use*
  • Cross-Linking Reagents / chemistry
  • Hyaluronic Acid / adverse effects
  • Hyaluronic Acid / chemistry
  • Hyaluronic Acid / therapeutic use*
  • Hydrogels / adverse effects
  • Hydrogels / chemistry
  • Hydrogels / therapeutic use*
  • Rabbits
  • Retina / drug effects
  • Retina / pathology
  • Retinal Detachment / surgery*
  • Silicone Oils / adverse effects
  • Silicone Oils / chemistry
  • Silicone Oils / therapeutic use*
  • Sulfhydryl Compounds / chemistry
  • Vitreous Body / surgery*

Substances

  • Biocompatible Materials
  • Cross-Linking Reagents
  • Hydrogels
  • Silicone Oils
  • Sulfhydryl Compounds
  • Hyaluronic Acid

Grants and funding

The study was supported by Croma Pharma, Leobendorf, Austria that provided the hydrogels and paid for some of the animal experiments. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.