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Comparative analysis between sclera treated with glycerin and sclera treated with gamma irradiation, alkali and glycerin in the reconstruction of anophthalmic socket: experimental study in rabbits

PURPOSE:To compare two sclera decontamination methods: treatment with glycerin versus treatment with gamma irradiation, alkali and glycerin, aiming to detect the clinical and histological alterations in rabbit anophthalmic sockets reconstructed with sclera-involved polymethylmethacrylate spheres. METHODS:Thirty-nine New Zealand-breed rabbits were divided into two groups: group I, whose animals were submitted to enucleation of one eye and reconstruction with a polymethylmethacrylate sphere involved in glycerin-treated sclera; group II, where there was enucleation, and reconstruction performed with a polymethylmethacrylate sphere involved in sclera treated with gamma irradiation, alkali and glycerin. The two groups were observed at four moments, at 7, 21, 42 and 84 days after surgery. Preset times elapsed, the rabbits were euthanized, sockets were exenterated, the material was processed for embedment in paraffin, cut into 5 µm sections thick and stained with hematoxylin-eosin and Masson's trichrome techniques. The scleras were submitted to morphometric and semiquantitative analysis. Results were compared by Mann-Whitney's non-parametric test. RESULTS: Comparative analysis of vascularization of the surgical interface pointed out a significative difference in the evaluation done 21 days after the implant (P<0.001), with group II showing greater neovascularization. Comparison of the fibrous capsule thickness displayed a significative difference at moments corresponding to 21 days (P<0.001) and 42 days (P<0.001). At both moments, group II presented a thicker fibrous capsule than group I. Likewise, there was variation in sclera thickness, being thicker in group II, at the 21-day post-implant (P=0.003) moment, and at the 42-day moment (P=0.024), as well. Along the experimental period, when groups were analyzed we could observe statistically significative diminution of vascularization in the surgical interface, in group I, as well as in group II, at the moment of 7, 21, 42 and 84 days. CONCLUSION: When used as coating on the polymethylmethacrylate implant for the reconstruction of rabbit anophthalmic socket, the sclera treated with gamma irradiation, alkali and glycerin reacted similarly to the traditionally used glycerin-treated sclera. The two treatments induced a similar inflammatory response. The formation of neovessels, thickness of fibrous capsule and of sclera developed differently in the two groups. Nevertheless, they presented similar results at the end of the 84-day observation period. There was no significant difference between the two groups, with regard to sclera preservation.

Sclera; Sclera; Decontamination; Eye enucleation; Orbital implants; Glycerol; Polymetylmethacrylate; Comparative study; Rabbits


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