Addition Of D-Sorbitol Improves The Usability Of Ophthalmic Viscosurgical Devices

Abstract

Purpose

To evaluate the effects of D-sorbitol addition on changes in the extrusion force of ophthalmic viscosurgical devices (OVDs).

Methods

OVD formulations; the mixtures of 3% hyaluronic acid (HA) and 4% chondroitin sulfate (CS) containing 0%, 0.5%, or 1.0% D-sorbitol were prepared. Each prefilled syringe of OVD was stored at room temperature for 0, 15, 30, 60, or 120 mins after a small amount of viscoelastic agent was discharged from the needle. The extrusion force values (kgf) of these OVDs when reused after storage were measured with a texture analyzer. Moreover, 10 healthy adults (5 men and 5 women) used a pinch sensor to measure the extrusion force values for the HA/CS combination without D-sorbitol which was stored in the above manner, and used a 4-step scale to score the usability of OVD.

Results

For the HA/CS combination without D-sorbitol, the extrusion force value was increased from its initial value (storage duration, 0 min) as storage duration increased. However, for the HA/CS combination containing 0.5% or 1.0% D-sorbitol, this value remained almost unchanged over time. Likewise, the pinch sensor-determined extrusion force values of HA/CS combination without D-sorbitol increased, depending on storage duration.

Conclusion

The addition of D-sorbitol to viscoelastic agent may suppress the needle clogging that occurs with OVD storage, and may improve the usability of OVDs during surgery.

Keywords:

• ophthalmic viscosurgical device
• extrusion force
• cataract surgery
• vitreous surgery

Abbreviations

BSS, balanced salt solution; CS, chondroitin sulfate; HA, hyaluronic acid; kgf, kilogram-force of extrusion force values; OVDs, ophthalmic viscosurgical devices, PBS, phosphate-buffered saline.

Acknowledgments

The questionnaire survey was supported by a collaboration between Santen Pharmaceutical Co., Ltd. (Japan) and Seikagaku Corp. The authors thank the staff of Seikagaku Corp. for their participation in this study using a pinch sensor. We also thank surgeons who answered the questionnaire. We thank Naoto Honda (Seikagaku Corp.) and Masakazu Kasahara (Seikagaku Corp.) for their technical assistance. The authors are grateful to Masataka Arihara (Seikagaku Corp.), Kiyoshi Suzuki (Seikagaku Corp.) and Jun Takeuchi (Seikagaku Corp.) for carefully reviewing the manuscript and helpful discussion. The authors also thank ASCA Corporation for language editing of this manuscript.

Author Contributions

All authors contributed to data analysis, drafting and revising the paper, gave approval for the final version to be published and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.