Our Summary

Eye doctors have been using a substance called hyaluronan (HA) to help with eye surgery for decades. However, it has limitations, especially when it comes to surgeries involving the back part of the eye, because it’s not strong enough. In this study, we created a modified version of HA, which becomes a gel-like substance when applied, and tested its effectiveness in a specific type of eye surgery using a lab model. We used a layer of a substance called triamcinolone acetonide as a stand-in for a part of the eye called the vitreous cortex.

Our modified HA, when used at the right concentration, created a gel that was just the right hardness to be manipulated with surgical tools. It was also able to enter the substitute vitreous cortex layer and remove almost half of it.

By studying the way the gel behaves, we found that the ideal concentration was between 0.97% and 1.30%. For instance, with a 1.30% concentration, the gel was hard enough for surgical use in just 3 minutes, and it was able to remove over 70% of the substitute vitreous cortex.

Our results show that this new, modified HA could potentially be a valuable tool in this type of eye surgery.

FAQs

  1. What is the function of hyaluronan products in ocular surgery?
  2. What is the significance of the in situ crosslinked hyaluronan (XL-HA) in vitrectomy surgery?
  3. How does the concentration of XL-HA affect its effectiveness in vitrectomy surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about ocular surgery is to follow all post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include using prescribed eye drops, avoiding rubbing or touching the eyes, and attending all follow-up appointments with your ophthalmologist.

Suitable For

Patients who may be recommended for ocular surgery include those with conditions such as retinal detachment, macular holes, diabetic retinopathy, cataracts, glaucoma, and other eye disorders that may require surgical intervention. These patients may benefit from the use of adjuncts such as in situ crosslinked hyaluronan (XL-HA) to improve the outcomes of their surgery.

Timeline

Before ocular surgery:

  1. Patient consults with ophthalmologist and undergoes pre-operative evaluations and tests.
  2. Patient receives instructions on pre-operative care, such as avoiding certain medications or fasting before surgery.
  3. Patient signs consent forms and discusses any concerns or questions with the surgical team.

During ocular surgery:

  1. Patient is prepped for surgery and given anesthesia.
  2. Ophthalmologist performs the surgery, which may involve procedures such as cataract removal, corneal transplant, or vitrectomy.
  3. Surgery may last anywhere from a few minutes to several hours, depending on the complexity of the procedure.
  4. Patient is monitored closely by the surgical team for any complications or adverse reactions.

After ocular surgery:

  1. Patient is taken to a recovery area and monitored for any immediate post-operative complications.
  2. Patient may experience blurred vision, discomfort, or light sensitivity in the hours following surgery.
  3. Patient receives post-operative instructions on medication use, eye care, and follow-up appointments.
  4. Patient is advised to rest and avoid strenuous activities for a period of time to allow for proper healing.
  5. Patient attends follow-up appointments with the ophthalmologist to monitor progress and address any concerns or complications.

What to Ask Your Doctor

  1. What is the purpose of using in situ crosslinked hyaluronan (XL-HA) in vitrectomy surgery?
  2. How does XL-HA compare to other ophthalmic viscoelastic devices commonly used in ocular surgery?
  3. What concentration of XL-HA is recommended for optimal results in vitrectomy surgery?
  4. How does XL-HA interact with other substances commonly used in ocular surgery, such as triamcinolone acetonide?
  5. What are the potential risks or side effects associated with using XL-HA in ocular surgery?
  6. How long does it take for XL-HA to form a hydrogel and reach the appropriate hardness for tweezers peeling?
  7. What is the success rate of XL-HA in removing residual vitreous cortex compared to other methods?
  8. How does the dynamic viscoelasticity of XL-HA contribute to its effectiveness in vitrectomy surgery?
  9. Are there any specific patient factors that may affect the suitability of using XL-HA in ocular surgery?
  10. What follow-up care or monitoring is necessary after using XL-HA in vitrectomy surgery?

Reference

Authors: Suzuki K, Watanabe I, Tachibana T, Mori K, Ishikawa K, Ishibashi T, Uchio E, Sonoda KH, Hisatomi T. Journal: J Mater Sci Mater Med. 2023 Nov 6;34(11):56. doi: 10.1007/s10856-023-06757-9. PMID: 37930485