Antiadhesive Effect of the Mixed Solution of Hyaluronate and Sodium Carboxymethylcellulose After Strabismus Surgery

Purpose: To evaluate the effect of the mixed solution of hyaluronate and sodium carboxymethylcellulose (HACMC, Guardix-sol) in reducing postoperative adhesion following strabismus surgery. Methods: In 16 rabbits out of 20 rabbits, 3 mm recession of the superior rectus muscle was performed on both eyes and HACMC solution was applied only to one eye which was randomly chosen. The rabbits were divided into a surgery-HACMC group and a surgery-no HACMC group. As a control group, the remaining 4 rabbits had no procedures performed. After 3 weeks, both eyes of 8 rabbits with surgery and 2 rabbits of the control group were enucleated. After staining with hematoxylin-eosin and Masson's trichrome, a histologic examination was performed. In the remaining 10 rabbits, the severity of adhesion in muscle and adjacent tissues was observed by blunt dissection. A researcher blind to the experiments performed all the examinations. Results: A significant reduction in the degree of adhesion (P=0.005) as well as decreased fibrosis (P=0.015) was observed in the surgery-HACMC group. Conclusions: The mixed solution of HACMC was effective in reducing postoperative adhesion after strabismus surgery in rabbits.