EVALUATION OF SURGICAL FACTORS AFFECTING VITREOUS HEMORRHAGE FOLLOWING PORT DELIVERY SYSTEM WITH RANIBIZUMAB IMPLANT INSERTION IN A MINIPIG MODEL.

Abstract

PURPOSE:

To develop an animal model of vitreous hemorrhage (VH) to explore the impact of surgical parameters on VH associated with insertion of the Port Delivery System with ranibizumab (PDS) implant.

METHODS:

Ninety eyes from 45 treatment-naive male Yucatan minipigs received PDS implant insertion or a sham procedure. The effect of prophylactic pars plana hemostasis, scleral incision length, scleral cauterization, surgical blade type/size, and viscoelastic usage on postsurgical VH was investigated.

RESULTS:

Postsurgical VH was detected in 60.0% (54/90) of implanted eyes. A systematic effect on VH was only detected for pars plana hemostasis before the pars plana incision. The percentage of eyes with VH was 96.6% (28/29) among eyes that did not receive prophylactic pars plana hemostasis and 42.4% (24/58) among eyes that did. There was no VH in eyes that received laser ablation of the pars plana using overlapping 1,000-ms spots; pars plana cautery or diathermy was less effective. The majority of all VH cases (83.3% [45/54]) were of mild to moderate severity (involving ≤25% of the fundus).

CONCLUSION:

In this minipig surgical model of VH, scleral dissection followed by pars plana laser ablation before pars plana incision most effectively mitigated VH secondary to PDS implant insertion.

• Authors: Vladimir Bantseev, Chris Schuetz, Helen S Booler, Joshua Horvath, Kristof Hovaten, Signe Erickson, Ellison Bentley, T Michael Nork, William R Freeman, Jay M Stewart, Giulio Barteselli
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 40 Issue 8 Pg. 1520-1528 (Aug 2020) ISSN: 1539-2864 [Electronic] United States
• PMID: 31436674 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Drug Implants
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Ranibizumab

Topics

• Angiogenesis Inhibitors (administration & dosage)
• Animals
• Disease Models, Animal
• Drug Delivery Systems
• Drug Implants
• Follow-Up Studies
• Homeostasis
• Intraocular Pressure (physiology)
• Male
• Ranibizumab (administration & dosage)
• Sclera (surgery)
• Swine
• Swine, Miniature
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)
• Vitreous Body (drug effects)
• Vitreous Hemorrhage (diagnosis, etiology, prevention & control)