Protective Properties of Viscoelastic Substances (Sodium Hyaluronate and 2% Hydroxymethylcellulose) Against Experimental Free Radical Damage to the Corneal Endothelium

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Abstract
Hydrogen peroxide (H2O2) has potent oxidant properties due to the action of free radicals (OH.) induced from its degradation. The free radicals specie derived from H2O2 are extremely toxic to the corneal endothelium and quickly induce corneal edema. In the present work, in order to ascertain the endothelial cell protection from viscoelastic substances, we have studied experimental corneal endothelial cell damage caused in the rabbit eye after intracameral injection of different H2O2 concentrations, with and without previous filling and washing out of two widely used viscoelastic substances from the anterior chamber such as 1% sodium hyaluronate (Healon) and hydroxypropylmethylcellulose (HPMC). We observed a dose-dependent endothelial damage in the controls. The experimental groups protected with Healon or HPMC showed statistically fewer corneal endothelial cell lesions than the control group (p < 0.001) for all of the concentrations used. Healon showed superior protective properties than HPMC at higher H2O2 concentrations (100 mM). However, HPMC was superior with 1 and 10 mM peroxide. From this experimental evidence, we conclude that Healon and HPMC are effective as protectors against the corneal endothelial lesions caused by free radicals. This finding may explain some of the beneficial effects of these viscoelastic substances.

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