Efficacy of Temperature-Sensitive Guardix-SG for Adhesiolysis in Experimentally Induced Eyelid Adhesion in Rabbits

PURPOSE: To determine the efficacy of a temperature-sensitive poloxamer/alginate mixture (Guardix-SG) for reducing adhesions after blepharoplasty in rabbit models. METHODS: Thirty-six intact eyes of 18 rabbits were randomly designated to 2 groups, and primary blepharoplasty was performed on both the upper eyelids of the 18 rabbits. Sterile cotton soaked in 1 N NaOH was used to produce chemical tissue damage to experimentally induce eyelid adhesion, which was followed by adhesiolysis in 2 weeks. During adhesiolysis, Guardix-SG was applied to the OD of rabbits in the experimental group, while adhesiolysis alone was performed on the OS of rabbits in the control group. Both sides were compared by gross examination 1 day, 1 week, and 4 weeks after surgery, and the degrees of inflammation and fibrosis were examined with hematoxylin-eosin (H&E) and Masson's trichrome (MT) stains. The expression of α-smooth muscle actin (α-SMA) antibody was also immunohistochemically examined. RESULTS: The gross examinations performed after adhesiolysis yielded results that were not significantly different between the experimental and the control groups, and no prevalent complications, such as eyelid traction or distorted eyelids, were observed. One day (p = 0.028), 1 week (p = 0.028), and 4 weeks (p = 0.028) after surgery, the experimental group had a lower infiltration rate of inflammatory cells than the control group, as shown by H&E staining. The MT staining and α-SMA staining also showed that the collagen deposition and fibrosis (1 week, p = 0.059; 4 weeks, p = 0.034) and the degree of myofibroblast differentiation were significantly lower in the experimental group than in the controls (1 week, p = 0.027; 4 weeks, p = 0.024). CONCLUSIONS: The temperature-sensitive poloxamer/alginate mixture (Guardix-SG) decreased inflammation and fibrosis after blepharoplasty and histopathologically prevented the readhesion of secondary blepharoplasty in rabbit models. Therefore, additional clinical studies are needed for other ophthalmic surgeries that could benefit from preventing postoperative adhesions.