Antioxidant Protection against Corneal Damage by Free Radicals during Phacoemulsification

Rubowitz, Alexander; Assia, Ehud I.; Rosner, Mordechai; Topaz, Morris

doi:10.1167/iovs.02-0892

Cited by 57 publications

(71 citation statements)

References 36 publications

(29 reference statements)

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“…Reports of corneal endothelial damage secondary to the use of ultrasound during phacoemulsification have been attributed to the release of free radicals due to cavitation. [131][132][133][134] However, the aqueous humor is rich in antioxidants, including ascorbic acid, and the lens has a coating of glutathione, another effective antioxidant. These endogenous antioxidants provide some endothelial protection.…”

mentioning

confidence: 99%

Potential Adverse Ultrasound-related Biological Effects

2011

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Ultrasound energy exerts important cellular, genetic, thermal, and mechanical effects. Concern about the safety of ultrasound prompted several agencies to devise regulatory limits on the machine output intensities. The visual display of thermal and mechanical indices during ultrasound imaging provides an aid to limit the output of the machine. Despite many animal studies, no human investigations conducted to date have documented major physiologic consequences of ultrasound exposed during imaging. To date, ultrasound imaging appears to be safe for use in regional anesthesia and pain medicine interventions, and adherence to limiting the output of ultrasound machines as outlined by the Food and Drug Administration may avoid complications in the future. This article reviews ultrasound-related biologic effects, the role of the regulatory agencies in ensuring safety with the use of ultrasound, and the limitations and implications of ultrasound use in humans. P IERRE Curie's discovery of the piezoelectric effect in 1880 launched the ultrasound technology revolution. This technology was first applied in ships for depth detection and in metallurgy for fracture identification, but medical applications were soon appreciated shortly thereafter.1 Medical ultrasound imaging has been used extensively for more than five decades, and the variety of uses for which this technology is used expanded rapidly. For example, the use of ultrasound for interventions during regional anesthesia and pain medicine allows the practitioner to reliably see the target, needle, and injectate with good resolution. 2 The primary advantages of ultrasound in these settings include real-time assessment, absence of radiation, decreased cost, and portability.2

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confidence: 99%

Potential Adverse Ultrasound-related Biological Effects

2011

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“…5 In addition, there are some recent studies that have shown that the phacoemulsification-associated endothelial injury may be caused by free radicals. [6][7][8][9] Based on these findings, it seems likely that the corneal endothelium can be damaged by free radicals during phacoemulsification because free radical species, hydroxyl radicals in particular, are highly reactive and can cause lethal injuries to cells. 10 The purpose of this study was to investigate the effects of free radicals on the corneal endothelium with special emphasis on histologic and immunohistochemical analyses after performing ultrasound oscillation in the anterior chambers of rabbit eyes.…”

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Corneal Endothelial Cell Damage by Free Radicals Associated With Ultrasound Oscillation

Murano

Ishizaki²,

Satō³

et al. 2008

Arch Ophthalmol

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To determine whether ultrasound oscillations in the anterior chamber cause corneal endothelial injury by free radicals.Methods: A phacoemulsification probe was introduced into the anterior chamber of rabbits' eyes through a limbal incision, and ultrasound oscillation was performed without emulsifying the lens. Rabbits were assigned to 4 treatment groups: (1) no treatment (controls); (2) only irrigation with a salt solution; (3) ultrasound only; and (4) ultrasound oscillations with a salt solution of 0.001M ascorbic acid. The corneas were immunohistochemically examined for oxidative stress using 8-hydroxy-2-deoxyguanosine (8-OHdG), apoptosis by terminal deoxynucleotidyl transferase-mediated dUTPbiotin nick-end labeling (TUNEL) staining, and ultrastructural changes by electron microscopy. The lipid peroxide levels in the aqueous humor were also measured.Results: In the ultrasound-only group, 8-OHdGpositive cells and TUNEL-positive cells were detected at 24 hours; necrotic cells were detected at 12 to 24 hours. Also, lipid peroxide levels were significantly increased at later times in the ultrasound group. Such changes were not observed in other groups. Conclusion:Free radicals induced by ultrasound oscillation can cause corneal endothelial damages.Clinical Relevance: Clinicians should be aware that free radicals associated with ultrasound oscillation can injure the corneal endothelial cells.

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“…A szabadgyök-képződés az egyik legfontosabb, a szür-kehályog-műtét során kialakuló endothelsejt-károsodás-hoz vezető folyamat [11][12][13][14][15].…”

Section: Eredeti Közleményunclassified

Szabadgyök-felszabadulás vizsgálata femtoszekundum lézerrel asszisztált capsulotomiát követően

et al. 2016

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Bevezetés: A femtoszekundum lézer alkalmazása forradalmi, innovatív kezelési eljárás a szürkehályog-sebészetben. Célkitűzés: Tanulmányunk célja a femtoszekundum lézeres capsulotomia során az elülső csarnokban képződő szabad gyök mennyiségének meghatározása sertésszemben. Módszer: Hetven friss sertésszemet vontunk be a vizsgálatba, amelyeket post mortem 2 órán belül 4 ºC hőmérsékleten szállítottunk, a kezelést pedig 7 órán belül végeztük el. Harmincöt szemet vizsgáltunk a kontroll-és a femtoszekundum lézeres capsulotomia csoportban is. Luminoldependens kemilumineszcens módszer segítségével vizsgáltuk a csarnokvíz szabadgyök-fogó kapacitását, mint a szabadgyök-termelődés indikátorát. Az emittált fotonok mennyiségét relatív fényegység százalékban fejeztük ki. Eredmé-nyek: A relatív fényegység százalék alacsonyabb volt a kontrollcsoportban (medián 1%, interkvartilis tartomány 0,4-3%), mint a femtoszekundum lézeres capsulotomia csoportban (medián 4,4%, interkvartilis tartomány 1,5-21%) (p = 0,01). Következtetések: A femtoszekundum lézeres capsulotomia gyengíti a csarnokvíz antioxidáns védelmét, amely a femtoszekundum lézeres capsulotomia során felszabaduló szabad gyökök hatására utal. Orv. Hetil., 2016, 157(47), 1880-1883.Kulcsszavak: kemilumineszcencia, kemilumineszcens femtoszekundum lézerrel asszisztált szürkehályog-műtét, szabad gyök, szabadgyök-fogó kapacitás Evaluation of free radical quantity in the anterior chamber following femtosecond laser-assisted capsulotomyIntroduction: Femtosecond laser is a revolutionary, innovative treatment method used in cataract surgery. Aim: To evaluate free radical quantity in the anterior chamber of the eye, during femtosecond laser assisted capsulotomy, in a porcine eye model. Method: Seventy fresh porcine eyes were collected within 2 hours post mortem, were transported at 4 ºC and treated within 7 hours. Thirty-five eyes were used as control and 35 as femtosecond laser assisted capsulotomy group. A simple luminol-dependent chemiluminescence method was used to measure the total scavenger capacity in the aqueous humour, as an indicator of free radical production. The emitted photons were expressed in relative light unit %. Results: The relative light unit % was lower in the control group (median 1%, interquartile range [0.4-3%]) than in the femtosecond laser assisted capsulotomy group (median 4.4%, interquartile range [1.5%-21%]) (p = 0.01). Conclusions: Femtosecond laser assisted capsulotomy decreases the antioxidant defense of the anterior chamber, which refers to a significant free radical production during femtosecond laser assisted capsulotomy.

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Antioxidant Protection against Corneal Damage by Free Radicals during Phacoemulsification

Cited by 57 publications

References 36 publications

Potential Adverse Ultrasound-related Biological Effects

Potential Adverse Ultrasound-related Biological Effects

Corneal Endothelial Cell Damage by Free Radicals Associated With Ultrasound Oscillation

Szabadgyök-felszabadulás vizsgálata femtoszekundum lézerrel asszisztált capsulotomiát követően

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