Hydrogen peroxide에 의한 실험적 각막내피세포손상에 대한 점탄물질, hyaluronic acid 및 ascorbic acid의 효과
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- In drder to nvestigate the protective effect of viscoelastics. hyaluronic acid and ascorbic acid on the corneal endothelial damage induced by perfusion with hydrogen peroxide, rabbit corneas were mounted in the in vitro dual-chambered specular microscope, and the corneal endothelial swelling was observed during perfusion with GBR solution containing hydrogen peroxide (0.25, 0.5 mM). The protective effects of hyaluronic acid (0.01%), viscoelastics (Healon, Viscoat), catalase, and ascorbic acid (0.5 mM, 1.0 mM, 3.0 mM) on the corneal endothelium were investigated at the specular microscopic and ultrastructural levels. Corneal thickness was measured every 15 minutes during the perfusion and a corneal swelling rate was calculated by linear regression analysis. At the end of perfusion, cornesas were fixed for transmission electron microscopy(TEM).
Hydrogen peroxide, at the concentration of 0.5 mM, caused marked corneal swelling while 0.25 mM not (65.95 ± 8.03 vs 6.69 ± 2.58 ㎛/hr). Healon prevented the H2O2 induced corneal swelling (15.85 ± 2.99 ㎛/hr. p＜0.01) and maintained the endothelial ultrastructures. Viscoat enabled the corneas to deswell (-35.90 ± 18.04 ㎛/hr. p＜0.01). Hyaluronic acid, at the concentration of 0.01% and catalase, at the dosage of 15,000 U also prevented corneal swelling induced by hydrogen peroxide (9.52 ± 3.361, 4.61 ± 0.99 ㎛/hr respectively). and maintained the endothelial ultrastructure. however 0.04% chondroitin sulfate showed marked corneal swelling (71.73 ± 2.12 ㎛/hr). Ascorbic acid, at the concentrations of 0.5 mM, 1.0 mM, and 3.0 mM, showed less corneal swelling than the control group (H2O2 0.5mM) of which difference was statistically significant (46.50 ± 7.76 ㎛/hr, 28.58 ± 5.89 ㎛/hr, 28.46 ± 2.92 ㎛/hr, respectively) (p＜0.05), gowever, the protective effect of ascorbic acid was not remarkable compapred to GBR perfusion. Furthermore, corneal endothelial ultrastructure was maintained in general although some intracytoplasmic vacuoles and dilatation of endoplasmic reticulum were observed. There was no differences in corneal swelling rate according to the concentration of ascorbic acid(p＞0.05). The results of this study showed that Healon and Viscoat containing hyaluronic acid prevent hydrogen peroxide-induced corneal endothelial damage, and ascorbic acid was marginally effective to prevent the corneal endothelial damage. Further study is required for the clinical use of these materials.
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