Please use this identifier to cite or link to this item: https://doi.org/10.1167/tvst.5.3.11
Title: Localized RPE Removal with a Novel Instrument Aided by Viscoelastics in Rabbits
Authors: Thieltges, Fabian
LIU ZENGPING 
Brinken, Ralf
Braun, Norbert
Wongsawad, Warapat
Somboonthanakij, Sudawadee
Herwig, Martina
Holz, Frank G
Stanzel, Boris V
Keywords: Science & Technology
Life Sciences & Biomedicine
Ophthalmology
AMD
Bruch's membrane
cell-based therapy
cell replacement
hyaluronic acid
hydrogel
retina
retinal surgery
RPE transplantation
tissue engineering
RETINAL-PIGMENT EPITHELIUM
HUMAN BRUCHS MEMBRANE
EMBRYONIC STEM-CELLS
MACULAR DEGENERATION
SUBRETINAL SPACE
IN-VIVO
TRANSPLANTATION
DEBRIDEMENT
LASER
SURVIVAL
Issue Date: 1-May-2016
Publisher: ASSOC RESEARCH VISION OPHTHALMOLOGY INC
Citation: Thieltges, Fabian, LIU ZENGPING, Brinken, Ralf, Braun, Norbert, Wongsawad, Warapat, Somboonthanakij, Sudawadee, Herwig, Martina, Holz, Frank G, Stanzel, Boris V (2016-05-01). Localized RPE Removal with a Novel Instrument Aided by Viscoelastics in Rabbits. TRANSLATIONAL VISION SCIENCE & TECHNOLOGY 5 (3). ScholarBank@NUS Repository. https://doi.org/10.1167/tvst.5.3.11
Abstract: Purpose: We developed a surgical method for localized and atraumatic removal of the retinal pigment epithelium (RPE) with a novel instrument. Methods: Bleb retinal detachments (bRD) were raised with balanced salt solution (BSS) following vitrectomy in 27 rabbits. The RPE was scraped with 3 loop variants (polypropylene [PP], 0.1 mm; PP, 0.06 mm; metal, 0.1 mm) of a custom-made instrument. Stabilization of bRDs with BSS or various concentrations (0.1%-0.5%) of hyaluronic acid (HA) was video analyzed. Perfusion-fixed samples of scraped areas and controls were studied by light and transmission electron microscopy. Results: The bRDs were sufficiently stabilized by ≥0.25% HA. Using the PP 0.1 mm loop with a single forward/backward stroke, an area of ca. 2.5 × 1.5 mm was nearly devoid of RPE, yet did show occasional Bruch’s membrane (BM) defects combined with choriocapillaris hemorrhages in 13% of the bRDs. A single scrape with PP 0.06 mm resulted in unsatisfactory RPE denudement, while repeated scraping maneuvers caused more BM defects and hemorrhages. The metal loop resulted in incomplete RPE removal and massive intraoperative subretinal hemorrhages. Histologically, intact photoreceptor outer segments (POS) were observed above the RPE wounds in bRDs. Controls with bRDs alone showed an intact RPE monolayer with microvilli, with few engulfed remains of POS. Conclusions: Localized removal of RPE in HA stabilized bRD can be achieved by a PP 0.1 mm loop instrument. Translational Relevance: Removal of degenerated RPE may aid RPE cell replacement strategies.
Source Title: TRANSLATIONAL VISION SCIENCE & TECHNOLOGY
URI: https://scholarbank.nus.edu.sg/handle/10635/206739
ISSN: 2164-2591
DOI: 10.1167/tvst.5.3.11
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