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The Protective Effect of Different Ophthalmic Viscoelastic Devices on Corneal Endothelial Cells During Phacoemulsificati

The Protective Effect of Different Ophthalmic Viscoelastic Devices on Corneal Endothelial Cells During Phacoemulsification In a Rabbit Model – Part I. Guy Kleinmann, M.D 1 Kfir Tal, M.S 2 Shmuel Ben Eliahu, D.V.M 3 Nathan Ezov, D.V.M 3 Asher Milshtein, MD 1.

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The Protective Effect of Different Ophthalmic Viscoelastic Devices on Corneal Endothelial Cells During Phacoemulsificati

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  1. The Protective Effect of Different Ophthalmic Viscoelastic Devices on Corneal Endothelial Cells During Phacoemulsification In a Rabbit Model – Part I Guy Kleinmann, M.D1 Kfir Tal, M.S2 Shmuel Ben Eliahu, D.V.M3 Nathan Ezov, D.V.M3 Asher Milshtein, MD1 1. Ophthalmology Department, Kaplan Medical Center, Affiliated to the Hebrew University and Hadassa, Jerusalem, Israel. 2. School of medicine, the Hebrew University, Jerusalem, Israel 3. Harlan Biotech Israel, Rehovot, Israel No financial disclosure

  2. Background Endothelial cell damage is one of the complication of Phacoemulsification Viscoelastic device (OVD) traditional classification: Higher viscosity (cohesive) maximize working space and stability of surgical environment Lower viscosity (dispersive) enhanced retention in the presence of fluid turbulence and endothelial protection

  3. Purpose To evaluate the protective effect of different OVDs on corneal endothlial cells during Phacoemulsification in an “extreme” model

  4. Hypothesis: The effect of the OVD will be more significant in a model with extensive damage to the endothelial cells. • First steps: • Finding the specular microscope that will read the rabbit eye: • Konan Noncon Robo SP 6000 • 2. Finding the model: • 90 sec Phaco 20-25% decrease in endothelial cell count

  5. Methods 24 NZW rabbit eyes 4 groups (6 eyes in each group): Control BiolonTM (Bio-Technology General Ltd.) Viscoat® (Alcon) Visiol® (TRB CHEMEDICA)

  6. Methods The aqueous humor was completely replaced by the examined material. The eyes were exposed to 90 seconds of continuous phacoemulsification. The handpiece was located in the center of the anterior chamber just adjacent to the lens capsule. Endothelial cell count was performed in all eyes prior to study initiation and 4 days post-surgery.

  7. Results Pre Post Difference Group A Control 3370 (+188) 2746 (+421)624 (18.7%) Group B Biolon 3212 (+183) 2408 (+329) 804 (25.1%) Group C Viscoat 3429 (+221)2386(+350) 1043 (30.1%) Group D Visiol 3371 (+105) 2615 (+153) 756 (22.3%) Differences not significant statistically

  8. Results Endothelial Cell Count Differences not significant statistically

  9. Exampale of pre-op specular microscopy

  10. Exampale of post-op specular microscopy

  11. Discussion Thermal energy may influence the results. Model too aggressive? Our results did not support the protective effect of any OVD on the endothelial cell in extreme phacoemulsification model. Further investigation should be preforme.

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