scholarly journals Does the Conjunctivochalasis Accompanied by Pseudoexfoliation Syndrome Affect the Ocular Surface and Anterior Segment Structures?

2022 ◽  
Author(s):  
Bediz Özen ◽  
Hakan Öztürk
Keyword(s):  
Anterior Chamber ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Tear Film ◽  
Disease Index ◽  
Pseudoexfoliation Syndrome ◽  
Group 3 ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Abstract Purpose: Probability of coexistence of conjunctivochalasis and pseudoexfoliation syndrome (PES) in same individual may increase with aging. We investigated effects of conjunctivochalasis accompanied by PES on ocular surface (OS) and anterior segment (AS) structures.Methods: Cases with only conjunctivochalasis were determined as group-1 (n=62), cases with conjunctivochalasis accompanied by PES as group-2 (n=45), and healthy cases as group-3 (n=56). OS and AS parameters of groups were compared.Results: Compared to group-1, group-2 had higher grade-3 conjunctivochalasis (17.7% vs 46.7%, p=0.039), greater mean grade of conjunctivochalasis (MGC) (1.72±0.24 vs 2.29±0.32, p=0.036), higher total conjunctivochalasis score (TCS) (4.27±1.13 vs 6.12±1.35, p=0.025), shorter tear-film break-up time (TBUT) (9.17±2.53 vs 5.41±1.32, p=0.010), greater OS disease index (OSDI)-score (16.28±3.15 vs 27.36±4.12, p=0.037). Compared to group-3, both group-1 and group-2 had shorter TBUT (group 3-1: p=0.004; group 3-2: p<0.001) and greater OSDI score (group 3-1: p=0.042; group 3-2: p=0.019). Schirmer tests, central corneal thicknesses, keratometries, axial lengths, anterior chamber depths and lens thicknesses of groups were similar (p>0.05). In group-1 and group-2, as age increased, both MGC (r=0.349, p=0.043; r=0.403, p=0.022, respectively) and TCS (r=0.322, p=0.046; r=0.372, p=0.031) increased. In group-2, as both MGC and TCS increased, TBUT (r=-0.370, p=0.034; r=-0.401, p=0.025) decreased and OSDI score (r=0.338, p=0.045; r=0.362, p=0.040) increased.Conclusions: To our knowledge, this was the first study comprehensively investigating effects of conjunctivochalasis accompanied by PES on OS and AS structures together. We found that conjunctivochalasis might cause OS disease, while presence of PES in conjunctivochalasis cases might worsen OS disease and conjunctivochalasis findings.

scholarly journals Effect of Autologous Serum Eyedrops on Ocular Surface Disease Caused by Preserved Glaucoma Eyedrops

2020 ◽  
Vol 9 (12) ◽  
pp. 3904
Author(s):  
Ha-Rim So ◽  
Hae Young Lopilly Park ◽  
So-Hyang Chung ◽  
Hyun-Seung Kim ◽  
Yong-Soo Byun
Keyword(s):  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Autologous Serum ◽  
Ocular Surface Disease Index ◽  
Ocular Surface Diseases ◽  
Group 3 ◽  
Baseline Values ◽  
Group 2 ◽  
Group 1

Autologous serum eyedrops (ASE) are effective in treating various ocular surface diseases, including damages induced by long-term use of preserved glaucoma eyedrops. However, there has been no study on whether ASE is effective without stopping the causative eyedrops. This retrospective observational study included 55 patients with ocular-surface diseases caused by long-term use of preserved glaucoma eyedrops: 18 patients who used ASEs for 2 months without discontinuing the use of glaucoma eyedrops (Group 1), 22 patients who used ASEs for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 2) and 15 patients who used non-preservative artificial tears for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 3). There were no intergroup differences in the baseline values of the Schirmer I test results, tear breakup time (TBUT), ocular surface staining (OSS) score, loss of the meibomian gland, meibum quality and ocular-surface disease index (OSDI). Group 1 showed significant differences in TBUT, OSS score and OSDI at 2 months when compared to the baseline values before treatment, while Group 2 showed significant differences in those values at both 1 and 2 months. There were no differences in any of the parameters at baseline, 1 month or 2 months in Group 3. Our result suggested that ASE is effective for treating ocular surface diseases caused by glaucoma eyedrops containing preservatives and its effects can be expected without interruption of glaucoma eyedrop treatment.

scholarly journals The effect of conjunctivochalasis detected by anterior segment optical coherence tomography on tear function in an elderly population

2020 ◽  
Vol 12 ◽  
pp. 251584142093087
Author(s):  
Dilay Ozek ◽  
Emine Esra Karaca ◽  
Ozlem Evren Kemer
Keyword(s):  
Ocular Surface ◽  
Elderly Population ◽  
Anterior Segment ◽  
Optic Coherence Tomography ◽  
Index Test ◽  
Test Results ◽  
Surface Staining ◽  
Tear Meniscus ◽  
Group 2 ◽  
Group 1

Introduction: The aim of this study was to evaluate conjunctivochalasis (CCH) and its relationship with tear meniscus and tear function in an elderly population. Materials and methods: This prospective, observational study included 144 eyes of 144 patients aged >65 years who were referred to our clinic for various reasons. The patients were separated into group 1 including 64 eyes of 64 patients with CCH and group 2 including 80 eyes of 80 patients without CCH. All patients in both groups underwent a full ophthalmological examination, and the presence of CCH, fluorescein tear break-up time (FTBUT) test, Schirmer test, ocular surface staining (Oxford grading score) and OSDI (Ocular Surface Disease Index) test results were recorded. Measurements of the conjunctivochalasis area (CCHA), tear meniscus height (TMH) and tear meniscus area (TMA) were taken using anterior segment optic coherence tomography (AS-OCT). Results: Group 1 comprised 34 females and 30 males with a mean age of 71.15 ± 12.34 years. Group 2 comprised 43 females and 37 males with a mean age of 68.16 ± 6.05 years ( p = 0.122). The CCH rate was 44.4% in all of the examined patients. The OSDI score and the ocular surface staining test were significantly higher ( p < 0.05), and the FTBUT, TMH and TMA were significantly lower ( p < 0.05) in group 1 than in group 2. The Schirmer I test results were not significantly different between the two groups. Conclusion: The prevalence of CCH is quite high in elderly individuals and may disrupt tear function in these patients.

scholarly journals The Injection of Air/Oxygen Bubble into the Anterior Chamber of Rabbits as a Treatment for Hyphema in Patients with Sickle Cell Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Emre Ayintap ◽  
Uğurcan Keskin ◽  
Fariz Sadigov ◽  
Mesut Coskun ◽  
Nilufer İlhan ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Sickle Cell ◽  
Aqueous Humour ◽  
Cell Disease ◽  
Air Bubble ◽  
Group 4 ◽  
Oxygen Bubble ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Purpose.To investigate the changes of partial oxygen pressure (PaO2) in aqueous humour after injecting air or oxygen bubble into the anterior chamber in sickle cell hyphema.Methods.Blood samples were taken from the same patient with sickle cell disease. Thirty-two rabbits were divided into 4 groups. In group 1 (n=8), there was no injection. Only blood injection constituted group 2 (n=8), both blood and air bubble injection constituted group 3 (n=8), and both blood and oxygen bubble injection constituted group 4 (n=8).Results.The PaO2in the aqueous humour after 10 hours from the injections was 78.45 ± 9.9 mmHg (Mean ± SD) for group 1, 73.97 ± 8.86 mmHg for group 2, 123.35 ± 13.6 mmHg for group 3, and 306.47 ± 16.5 mmHg for group 4. There was statistically significant difference between group 1 and group 2, when compared with group 3 and group 4.Conclusions.PaO2in aqueous humour was increased after injecting air or oxygen bubble into the anterior chamber. We offer to leave an air bubble in the anterior chamber of patients with sickle cell hemoglobinopathies and hyphema undergoing an anterior chamber washout.

Changes in conjunctival epithelial cells after treatment with 0.2% xanthan gum eye drops in mild-moderate dry eye

2019 ◽  
Vol 30 (3) ◽  
pp. 439-445
Author(s):  
Elisa Imelde Postorino ◽  
Pasquale Aragona ◽  
Laura Rania ◽  
Rosaria Spinella ◽  
Domenico Puzzolo ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Xanthan Gum ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Eye Drops ◽  
Impression Cytology ◽  
Ocular Surface Disease Index ◽  
Group 2 ◽  
Group 1

Purpose: To study the effects of xanthan gum eye drops on the ocular surface and conjunctival cytology of patients with mild-moderate dry eye. Methods: This prospective, double-masked, controlled trial included 30 patients (age > 60 and Ocular Surface Disease Index score >12 and <33), divided into two groups of 15 subjects and treated with 0.2% xanthan gum eye drops (group 1) or 0.5% carboxymethylcellulose (group 2) qid. After a run-in period with saline qid, patients were evaluated by Ocular Surface Disease Index questionnaire, clinical assessment, and impression cytology at baseline (T0) and after 1 month (T1). For impression cytology, cellularity, cell-to-cell contacts, nucleus/cytoplasm ratio, chromatin aspect, goblet cells distribution, keratinization, and the presence of inflammatory cells were considered. Parameters were scored from 0 (no alterations) to 3 (evident alterations). For statistical analysis, Student’s t-test, Wilcoxon rank-sum test, and Mann–Whitney U-test were used. Results: Clinically, after 1 month of treatment, group 1 showed an improvement of corneal stain (T0 = 1.1 ± 1.4; T1 = 0.5 ± 0.7; p = 0.03) and a reduction of Schirmer I test (T0 = 9.8 ± 6.1; T1 = 5.9 ± 4.1; p = 0.001). In group 2, no differences were found between T0 and T1 for all the clinical tests. For impression cytology, in group 1 cellularity (T0 = 0.6 ± 0.5; T1 = 0.3 ± 0.5; p = 0.05), chromatin aspect (T0 = 1.2 ± 0.4; T1 = 0.8 ± 0.5; p = 0.01), keratinization (T0 = 1 ± 0.7; T1 = 0.5 ± 0.5; p = 0.03), and total score (T0 = 5.8 ± 1.3; T1 = 3.6 ± 1.7; p = 0.003) were significantly ameliorated, while in group 2 only total score improved significantly (T0 = 5 ± 1.4; T1 = 4.3 ± 1.5; p = 0.01). The comparison between groups showed significant amelioration for keratinization in group 1 at T1 (p = 0.02). Conclusion: The treatment with xanthan gum, a molecule with anti-oxidant and mucoadhesive properties, ameliorated conjunctival epithelium of mild-moderate dry eye patients better than carboxymethylcellulose.

Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients

2021 ◽  
pp. 112067212110065
Author(s):  
Pelin Kiyat ◽  
Melis Palamar ◽  
Bengu Gerceker Turk
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Surface Damage ◽  
Meibomian Gland ◽  
Drop Out ◽  
Meibomian Gland Dysfunction ◽  
Ocular Surface Disease Index ◽  
Group 2 ◽  
Group 1

Purpose: To analyze the relation between Meibomian gland dysfunction, dry eye, and sarcoidosis. Materials and Methods: Twenty eyes of 10 sarcoidosis patients (Group 1) and 20 left eyes of 20 age-sex matched healthy volunteers (Group 2) were included. Presence of dry eye was evaluated with Schirmer 1 test, tear film break-up time (T-BUT), Oxford scale scoring, Ocular Surface Disease Index (OSDI) score assessments. A slit-lamp biomicroscope infrared filter (Topcon, SL-D701, IJssel, The Netherlands) was used to evaluate Meibomian glands. The drop-out ratio according to meibography was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area >2/3 of the total Meibomian gland area). Results: Among dry eye tests mean Schirmer 1 and T-BUT values were lower and OSDI score was higher in Group 1 compared to Group 2 and the differences were statistically significant ( p = 0.017, p = 0.039, p = 0.003, respectively). In addition, the upper, lower and total meiboscores were statistically significantly higher in Group 1 ( p = 0.047, p = 0.003, p = 0.005, respectively). Conclusion: A significantly higher presence of dry eye and Meibomian gland drop out ratios was detected in sarcoidosis patients. It is important to monitor sarcoidosis patients for dry eye and Meibomian gland dysfunction and when detected, to treat adequately to prevent ocular surface damage.

scholarly journals PROTEOMIC DIAGNOSTIC TECHNOLOGIES AND THEIR APPLICATION FOR THE REFRACTIVE CORRECTION OF AMETROPIA

2017 ◽  
Vol 12 (4) ◽  
pp. 193-199
Author(s):  
M. A Kovalevskaya ◽  
I. V Chernikova ◽  
V. S Podoprigora ◽  
Mariya I. Sergeeva
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Syndrome ◽  
Tear Fluid ◽  
Antioxidant Protection ◽  
Before And After ◽  
Group 3 ◽  
Group 2 ◽  
High Degree ◽  
Group 1

Aim. The objective of the present study was the analysis of the tear fluid proteomic status and the eye surface of the patients presenting with ametropia before and after laser-assisted in situ keratomileusis (LASIK). Material and methods. The study included 163 patients (326 eyes) divided into three groups. Group 1 was comprised of 51 adult patients (102 eyes)at the age from 35 to 54 years suffering from high-degree myopia and astigmatism. Group 2 was composed of 26 adult patients (52 eyes) at the age from 35 to 55 years suffering from moderate or high-degree hyperopia and astigmatism. Group 3 consisted of 86 younger patients (172 eyes) at the age from 18 to 54 years suffering from high-degree myopia and astigmatism. The dry eye syndrome and the state pf the cornea were diagnosed with the use of the Lipkof’s test, Schirmer’s test, TBUT test, and corneal fluorescence staining. The antioxidant activity of the tears was estimated based on the results of measurements of peroxyredoxin-6 (PEDX6) expression. Results. The level of PEDX6 expression after LASIK increased in the patients presenting with myopia by 1.4 times and in those with hyperopia by 1.07 times, that is it changed but slightly after the operation and was 6.2 times less pronounced in comparison was the myopes. Conclusion. The study has demonstrated that two methods proved reliable for the evaluation of the tear fluid proteomic status, viz. the Lipkof’s test (1.82 ± 0.2mm, stage 3) and the TBUT test (8.0 ± 1.46 seconds), suggesting the presence of grade 2 dry eye syndrome. Te same refers to the patients of group 2: the results of the Lipkof’s test (1.31 ± 0.2mm) and the TBUT test (8.23 ± 0.87 seconds). The level of antioxidant protection of the ocular surface (PEDX6 expression) depended on the type of the refractive error: in the patients of group 1 before and after LASIK, PEDX6 expression was 4.7 times (13.57 ± 0.83) and 6.2 (19.31 ± 0.71) higher 2.88 ± 0.38 and 3.09 ± 0.47) than in those of group 2, respectively. In addition, it was shown that the level of antioxidant protection of the ocular surface (PEDX6 expression) depended on the age of the patients prior to LASIK: it was 1.3 lower in group 1 than in group 3 (1.35 ± 0.83 and 17.77 ± 1.03 respectively). The clinical significance of the tests for the tear fluid production and proteomic status changed appreciably after LASIK. The TBUT test for diagnostics of dry eye syndrome remained reliable in all the groups.

Rituximab Plus GM-CSF for Patients with Chronic Lymphocytic Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 721-721 ◽  
Author(s):  
Alessandra Ferrajoli ◽  
Susan M. O’Brien ◽  
Stefan H. Faderl ◽  
William G. Wierda ◽  
Farhad Ravandi-Kashani ◽  
...  
Keyword(s):  
Single Agent ◽  
Lymphocytic Leukemia ◽  
Gm Csf ◽  
Cd20 Expression ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Group 3 ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Abstract Treatment with single agent rituximab is associated with overall response (OR) rate of 15–35% in previously treated patients and up to 44% in untreated patients with CLL. The majority of the responses are partial (PR). GM-CSF was found to increase surface CD20 expression in vitro and potentiate ADCC and therefore improve the efficacy of rituximab. The combination of rituximab and GM-CSF has been investigated in follicular lymphomas and found to be associated with significant responses (McLaughlin et al. Ann. Oncol16:v68, 2005). Therefore, we designed a phase II study of rituximab plus GM-CSF in CLL. Patients were eligible for this study if they belonged to one of the following: Group 1: previously untreated patients, Rai stage 0-II and b2M &gt;3 mg/mL, B symptoms or significant fatigue. Group 2: previously untreated patients ≥ 70 years with indication for treatment (NCI-WG criteria). Group 3: previously treated patients with evidence of active disease (NCI-WG criteria). All patients received 4 weekly infusions of rituximab 375 mg/m2 plus GM-CSF 250 mcg sc three times a week for 8 weeks. Prior to study entry patients were evaluated for genomic aberration (FISH), IgVH mutation status, ZAP70 expression, and number of CD20 antigen sites. Changes in self-reported fatigue were measured using the FACT-An fatigue scale. Eighty-two patients have been enrolled at this time and 55 are evaluable for response and toxicity. Responses (NCI-WG): Pts CR (%) NPR (%)* PR (%) OR (%) *Nodular PR:residual lymphoid nodules present Group 1 9 7 7 (78) Group 2 20 3 2 12 17 (85) Group 3 26 2 3 9 14 (54) OVERALL 55 5 (9) 5 (9) 28 (51) 38 (69) Toxicities attributable to the administration of GM-CSF consisted in Grade 1 injection site reactions in 25% and Grade 1–2 bone pain in 13%. Grade 3 thromobocytopenia was observed in 2% of the patients and Grade 3–4 neutropenia in 4%. Grade 3 infections were observed in 9% of the patients. The following characteristics were correlated with responses. Characteristic Patients CR% OR% FISH 11q-/17p-11 1 (9) 4 (36) 13q-/+12/normal 38 4 (11) 32 (84) p&lt;.001 IgVH Unmutated 23 1 (4) 11 (48) Mutated 28 4 (14) 23 (82) p=.01 ZAP70 Positive 30 1 (3) 17 (57) Negative 23 4 (17) 17 (74) p=NS CD20 sites/cell ≤10,000 20 10 (50) &gt;10,000 16 3 (19) 13 (81) p=.05 Treatment with rituximab plus GM-CSF was associated with a reduction of self-reported fatigue (median score reduction 7 points) in two thirds of the patients. In conclusion, the combination of rituximab plus GM-CSF is well tolerated and associated with an encouragingly high response rate. Favorable genomic profile, mutated IgVH status and high level of CD20 expression predicted for response to this combination. Ongoing correlative studies aim to clarify the mechanism of action of this combination. Accrual to this study is ongoing.

Pegylated liposomal doxorubicin (PLD) and gemcitabine (GEM) in combination in the salvage treatment of epithelial ovarian cancer (OC)—a Danish Gynaecologic Cancer Group (DGC) study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5094-5094
Author(s):  
M. R. Mirza ◽  
B. Lund ◽  
K. Bertelsen ◽  
J. Lindegaard ◽  
N. Keldsen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Dose Escalation ◽  
Pegylated Liposomal Doxorubicin ◽  
Short Treatment ◽  
Cancer Group ◽  
Gynaecologic Cancer ◽  
Group 3 ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

5094 Background: Ovarian cancer patients (pts) recurring with a short treatment-free interval (TFI) after prior chemotherapy (PCT) have a bad prognosis. DGC has conducted a phase II study of PLD-GEM in combination in OC pts recurring with a TFI of less than 12 months (mo). Methods: All pts must have received at least one platinum-paclitaxel containing regimen; no PCT with GEM or anthracyclines. Regimen: GEM 800mg/m2 day 1+8 and PLD 25mg/m2 day 1, q 21 days. GEM dose escalation to 1g/m2 day 1+8 from 2. cycle in the absence of grade 3–4 toxicity. Primary end point: OS, secondary: PFS, response and toxicity. Pts were grouped according to their response to PCT. Group 1: pts with CR on PCT and TFI 3–12 mo; group 2: pts with CR on PCT and TFI 0–3 mo; group 3: pts with PR/SD on PCT and TFI 0–12 mo. 35 pts with ≥2 prior number of treatments. Results: 82 pts were enrolled (May 2003-Aug 2005); the median age was 59 yrs (range 31 to 77 yrs); 15 pts were entered with rising CA125 only (GCIG criteria). Groups according to their response to PCT: group 1: 44 pts; group 2: 5 pts; group 3: 33 pts. TFI ≤ 6 mo 33 pts, TFI > 6 to ≤ 12 mo 49 pts. To date data on 330 cycles (mean 4.7 cycles) is available; 45 pts are evaluable for PFS and OS; 62 pts are evaluable for response and 71 pts for toxicity. Grade 3–4 toxicity: PPE 6/330 cycles; mucosites 8/330 cycles; febrile neutropenia 4%; treatment delay 9%. No dose reductions performed for PLD. GEM dose escalation to 1000 mg/m2 in 31 pts; dose reduction to 650 mg/m2 at any time in 21 pts; skipped dose day 8 in 44 cycles. Response (RESIST): CR 3 pts; PR 17 pts (CR+PR 32%); SD 39 pts; PD 2 pts. Median PFS 212 days, Median OS 234 days. Conclusions: PLD-GEM in combination in the salvage setting is well tolerated, with acceptable toxicity and clear activity. No significant financial relationships to disclose.

scholarly journals The Effects of Ramadan Fasting on Anterior Segment Parameters, Visual Acuity and Intraocular Pressures of the Eye

2017 ◽  
Vol 11 (1) ◽  
pp. 152-155 ◽  
Author(s):  
Ozlem Barut Selver ◽  
Melis Palamar ◽  
Kevser Gerceker ◽  
Sait Egrilmez ◽  
Ayse Yagci
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Ophthalmological Examination ◽  
Significant Difference ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Objective: It is aimed to determine whether fasting during Ramadan has any significant effect on anterior chamber parameters, visual acuity and intraocular pressures. Methods: 31 fasting (Group 1) and 30 non-fasting healthy volunteers (Group 2) were enrolled. All cases underwent an ophthalmological examination and anterior segment parameter evaluation (central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pupil size) with Pentacam before and after the breaking of the Ramadan fast in Group 1, before and after dinner in Group 2. Results: The mean age was 43.35 ± 13.20 in Group 1, 43.17 ± 12.90 in Group 2 (p= 0.955). No significant difference was detected in any of the parameters in both groups. Conclusion: There is a need for more detailed and associated studies to understand better about the influence of Ramadan fast on various ocular parameters.

scholarly journals EFFECT OF HYALURONIC ACID ON THE HEALING OF COLONIC ANASTOMOSIS IN RATS TREATED WITH CORTICOID

2020 ◽  
Vol 11 (2) ◽  
pp. 81-92
Author(s):  
Iana Campinho Braga de Araújo Lima ◽  
´´Italo Medeiros Azevedo ◽  
Keyla Borges Ferreira Rocha ◽  
Aldo Cunha Medeiros
Keyword(s):  
Hyaluronic Acid ◽  
Inflammatory Response ◽  
Systemic Corticosteroid ◽  
Colonic Anastomosis ◽  
Anastomosis Site ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Objective: This study aimed at examining whether topical treatment of colon anastomosis with hyaluronic acid can influence the healing of colonic anastomosis in rats treated with systemic corticosteroid. Methods: Three groups of Wistar rats weighing 252 ± 7g were used, with six rats each, all submitted to anastomosis of the proximal colon: Group 1 - control rats, without treatment. Group 2 - rats treated with subcutaneous (s.c) corticosteroid, and topical application of 0.9% saline solution over the anastomosis. Group 3 - rats treated with corticosteroid s.c. and topical application of 0.4% hyaluronic acid (10 mg/ml) on colonic anastomosis. On the 7th postoperative day, under anesthesia and laparotomy, the anastomosis site was subjected to the determination of rupture pressure. Then, samples containing the anastomosis site were resected and fixed in 10% buffered formaldehyde and embedded in paraffin. Masson H-E and trichrome staining. Histometry evaluated the infiltration of inflammatory cells at the anastomosis site, using a numerical scale from 0 to 4. Continuous variables were assessed using the Tukey test. Differences considered significant with p<0.05. Results: All animals survived the experiments. There were no abscesses, fistulas and macroscopically detectable dehiscences in the anastomosis site. The weight of the animals on the 7th postoperative day showed a statistically significant difference (p<0.001) between the control (253.6±6.3g) and corticoid (221.6±15.4g) groups, as well as between the corticoid +. hyaluronic acid group (257.8±9.7g) and corticosteroids (221.6±15.4). There was no significant difference in the comparison between the control and corticoid + hyaluronic acid groups (p>0.05). In the analysis of intraluminal pressure of colonic anastomosis, there was a statistically significant difference when comparing groups 1 (286.8±9.9 mmHg) and 2 (155±6.0 mmHg), 1 (286.8±9,9 mmHg) and 3 (199.1±7.7) and 2 (155±6.0 mmHg) and 3 (199.1±7.7), with p<0.001 for all comparisons. Histopathological classification by the numerical scale: Group 1 - inflammatory response (H-E) grade 3 and collagen deposition by Masson Trichomic grade 1; Group 2 - inflammatory response (H-E) grade 4 and deposition of collagen and fibroblasts by Masson's Trichrome grade1\2; Group 3 - inflammatory response (H-E) grade 3 and deposition of collagen and fibroblasts by Masson's Trichrome grade 1\2. There was no significant difference between groups. Conclusion: The topical use of hyaluronic acid has a positive influence on the initial healing phase of colonic anastomosis in rats treated with systemic corticosteroid.

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