Reduced need for corneal epithelial debridement during vitreo-retinal surgery using two different viscous surface lubricants

Enrique Garcia-Valenzuela, Ahmed Abdelsalam, Dean Eliott, Mauricio Pons, Raymond Iezzi, James E. Puklin, Mark L. McDermott, Gary W. Abrams

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

PURPOSE: Corneal clarity is frequently reduced during vitrectomy and scleral buckling surgery secondary to epithelial edema, requiring epithelial debridement to improve visibility. The presence of toxic preservatives in the corneal lubricant solutions is hypothesized to be a contributing factor to epithelial edema during vitreo-retinal surgery. DESIGN: Interventional study. METHODS: We compared prospectively the corneal clarity and epithelial debridement frequency in 71 patients within a single institution in whom either Goniosol (2.5% methylcellulose, boric acid, edetate disodium, sodium borate, potassium chloride, water, and 0.01% benzalkonium chloride) or GenTeal gel (0. 3% hydoxypropyl-methylcellulose, carbopol 980, phosphonic acid, sorbitol, water, and 0.028% sodium perborate) was used as a corneal lubricant during the course of vitrectomy surgery using sutured contact lenses. Corneal clarity was subjectively graded in a scale of I to IV during surgery. Statistical analysis was made between these two groups for parametric and categorical data. RESULTS: All eyes started with a corneal clarity grade of I (best possible). Corneal clarity decreased significantly faster in eyes where Goniosol was used to a median grade of III at 1 hour of surgical time. In eyes where GenTeal gel was used, corneal clarity decreased much slower, to a median grade of I at 1 hour of surgical time. The difference in frequency of epithelial debridement was also statistically significant: 54% and 14% for Goniosol and GenTeal eyes, respectively. Other factors that may cause corneal epithelial edema and affect corneal clarity were not statistically different between the Goniosol and the GenTeal groups, including median operative time, estimated intraocular pressure, pre- and intraoperative topical solutions and medications, and number of prior ocular procedures. CONCLUSIONS: The use of GenTeal gel as a corneal lubricant maintains corneal clarity longer than Goniosol during the course of vitrectomy surgery using a contact lens viewing system, limiting the need for epithelial debridement.

Original languageEnglish (US)
Pages (from-to)1062-1066
Number of pages5
JournalAmerican Journal of Ophthalmology
Volume136
Issue number6
DOIs
StatePublished - Dec 2003
Externally publishedYes

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Lubricants
Debridement
Vitrectomy
Operative Time
sodium perborate
Methylcellulose
Gels
Contact Lenses
Edema
Scleral Buckling
Benzalkonium Compounds
Corneal Edema
Potassium Chloride
Sorbitol
Water
Poisons
Intraocular Pressure

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Garcia-Valenzuela, E., Abdelsalam, A., Eliott, D., Pons, M., Iezzi, R., Puklin, J. E., ... Abrams, G. W. (2003). Reduced need for corneal epithelial debridement during vitreo-retinal surgery using two different viscous surface lubricants. American Journal of Ophthalmology, 136(6), 1062-1066. https://doi.org/10.1016/S0002-9394(03)00634-2

Reduced need for corneal epithelial debridement during vitreo-retinal surgery using two different viscous surface lubricants. / Garcia-Valenzuela, Enrique; Abdelsalam, Ahmed; Eliott, Dean; Pons, Mauricio; Iezzi, Raymond; Puklin, James E.; McDermott, Mark L.; Abrams, Gary W.

In: American Journal of Ophthalmology, Vol. 136, No. 6, 12.2003, p. 1062-1066.

Research output: Contribution to journalArticle

Garcia-Valenzuela, E, Abdelsalam, A, Eliott, D, Pons, M, Iezzi, R, Puklin, JE, McDermott, ML & Abrams, GW 2003, 'Reduced need for corneal epithelial debridement during vitreo-retinal surgery using two different viscous surface lubricants', American Journal of Ophthalmology, vol. 136, no. 6, pp. 1062-1066. https://doi.org/10.1016/S0002-9394(03)00634-2
Garcia-Valenzuela, Enrique ; Abdelsalam, Ahmed ; Eliott, Dean ; Pons, Mauricio ; Iezzi, Raymond ; Puklin, James E. ; McDermott, Mark L. ; Abrams, Gary W. / Reduced need for corneal epithelial debridement during vitreo-retinal surgery using two different viscous surface lubricants. In: American Journal of Ophthalmology. 2003 ; Vol. 136, No. 6. pp. 1062-1066.
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abstract = "PURPOSE: Corneal clarity is frequently reduced during vitrectomy and scleral buckling surgery secondary to epithelial edema, requiring epithelial debridement to improve visibility. The presence of toxic preservatives in the corneal lubricant solutions is hypothesized to be a contributing factor to epithelial edema during vitreo-retinal surgery. DESIGN: Interventional study. METHODS: We compared prospectively the corneal clarity and epithelial debridement frequency in 71 patients within a single institution in whom either Goniosol (2.5{\%} methylcellulose, boric acid, edetate disodium, sodium borate, potassium chloride, water, and 0.01{\%} benzalkonium chloride) or GenTeal gel (0. 3{\%} hydoxypropyl-methylcellulose, carbopol 980, phosphonic acid, sorbitol, water, and 0.028{\%} sodium perborate) was used as a corneal lubricant during the course of vitrectomy surgery using sutured contact lenses. Corneal clarity was subjectively graded in a scale of I to IV during surgery. Statistical analysis was made between these two groups for parametric and categorical data. RESULTS: All eyes started with a corneal clarity grade of I (best possible). Corneal clarity decreased significantly faster in eyes where Goniosol was used to a median grade of III at 1 hour of surgical time. In eyes where GenTeal gel was used, corneal clarity decreased much slower, to a median grade of I at 1 hour of surgical time. The difference in frequency of epithelial debridement was also statistically significant: 54{\%} and 14{\%} for Goniosol and GenTeal eyes, respectively. Other factors that may cause corneal epithelial edema and affect corneal clarity were not statistically different between the Goniosol and the GenTeal groups, including median operative time, estimated intraocular pressure, pre- and intraoperative topical solutions and medications, and number of prior ocular procedures. CONCLUSIONS: The use of GenTeal gel as a corneal lubricant maintains corneal clarity longer than Goniosol during the course of vitrectomy surgery using a contact lens viewing system, limiting the need for epithelial debridement.",
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AU - Garcia-Valenzuela, Enrique

AU - Abdelsalam, Ahmed

AU - Eliott, Dean

AU - Pons, Mauricio

AU - Iezzi, Raymond

AU - Puklin, James E.

AU - McDermott, Mark L.

AU - Abrams, Gary W.

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N2 - PURPOSE: Corneal clarity is frequently reduced during vitrectomy and scleral buckling surgery secondary to epithelial edema, requiring epithelial debridement to improve visibility. The presence of toxic preservatives in the corneal lubricant solutions is hypothesized to be a contributing factor to epithelial edema during vitreo-retinal surgery. DESIGN: Interventional study. METHODS: We compared prospectively the corneal clarity and epithelial debridement frequency in 71 patients within a single institution in whom either Goniosol (2.5% methylcellulose, boric acid, edetate disodium, sodium borate, potassium chloride, water, and 0.01% benzalkonium chloride) or GenTeal gel (0. 3% hydoxypropyl-methylcellulose, carbopol 980, phosphonic acid, sorbitol, water, and 0.028% sodium perborate) was used as a corneal lubricant during the course of vitrectomy surgery using sutured contact lenses. Corneal clarity was subjectively graded in a scale of I to IV during surgery. Statistical analysis was made between these two groups for parametric and categorical data. RESULTS: All eyes started with a corneal clarity grade of I (best possible). Corneal clarity decreased significantly faster in eyes where Goniosol was used to a median grade of III at 1 hour of surgical time. In eyes where GenTeal gel was used, corneal clarity decreased much slower, to a median grade of I at 1 hour of surgical time. The difference in frequency of epithelial debridement was also statistically significant: 54% and 14% for Goniosol and GenTeal eyes, respectively. Other factors that may cause corneal epithelial edema and affect corneal clarity were not statistically different between the Goniosol and the GenTeal groups, including median operative time, estimated intraocular pressure, pre- and intraoperative topical solutions and medications, and number of prior ocular procedures. CONCLUSIONS: The use of GenTeal gel as a corneal lubricant maintains corneal clarity longer than Goniosol during the course of vitrectomy surgery using a contact lens viewing system, limiting the need for epithelial debridement.

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