Assessment of a self-assembling peptide gel, SPG-178, in providing a clear operative field for trabeculectomy surgery for glaucoma in an animal model
Assessment of a self-assembling peptide gel, SPG-178, in providing a clear operative field for trabeculectomy surgery for glaucoma in an animal model
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评估自组装肽凝胶 SPG-178 在动物模型中为青光眼小梁切除手术提供清晰的手术视野
DOI：
10.1038/s41598-020-68171-3
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发表时间：
2020
影响因子：
4.6
通讯作者：
Nishida Kohji
中科院分区：
文献类型：
--
作者：
Matsushita Kenji;Kawashima Rumi;Uesugi Koji;Okada Haruka;Sakaguchi Hirokazu;Quantock Andrew J.;Nishida Kohji
眼科手术期间血液的存在是有问题的，因为它会妨碍外科医生观察手术区域。当进行小梁切除手术以增强眼液流出并降低眼压以治疗青光眼（全球最常见的视力丧失疾病之一）时尤其如此。在这项研究中，我们研究了透明自组装肽凝胶 (SPG-178) 的性能及其在小梁切除术期间保持可见性的能力。与眼科手术中常用的透明质酸凝胶不同，SPG-178 不允许血液进入凝胶本身。相反，它迫使血液从外周流向凝胶。此外，如果 SPG-178 凝胶下发生出血，用生理盐水灌注能够有效地将血液沿着 SPG-178 和眼部组织（在本例中为巩膜）之间的界面冲走，以清除手术视野。在使用丝裂霉素 C 作为辅助剂的实验性小梁切除术中，使用或不使用 SPG-178 术后眼压或滤泡形态的恢复没有差异。因此，当用于凝胶制剂时，SPG-178 代表了一种用于眼内手术的新材料，可确保清晰的手术视野，并可能产生有益的治疗结果。
The presence of blood during ophthalmic surgery is problematic, as it can obstruct a surgeon’s view of the operative field. This is particularly true when performing trabeculectomy surgery to enhance ocular fluid outflow and reduce intraocular pressure as a treatment for glaucoma, one of the most common vision loss conditions worldwide. In this study, we investigated the performance of a transparent, self-assembling peptide gel (SPG-178) and its ability to maintain visibility during trabeculectomy surgery. Unlike the hyaluronic acid gel commonly used in ophthalmic surgery, SPG-178 did not permit the ingress of blood into the gel itself. Rather, it forced blood to flow peripherally to the gel. Moreover, if bleeding occurred under the SPG-178 gel, perfusion with saline was able to effectively flush the blood away along the interface between the SPG-178 and the ocular tissue (in this case scleral) to clear the surgical field of view. In experimental trabeculectomy surgeries with mitomycin C used as an adjuvant, there were no differences in the postoperative recovery of intraocular pressure or bleb morphology with or without the use of SPG-178. SPG-178, therefore, when used in a gel formulation, represents a new material for use in intraocular surgery to ensure a clear operative field with likely beneficial treatment outcomes.