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Anterior ciliary sclerotomy: effect on corneal topography, globe integrity, and the role of a novel antifibrotic gel

To (1) quantify changes in corneal topography induced by radial anterior sclerostomy for restoring accommodation and, (2) assess safety and ant fibrosis activity of cross-linked sodium hyaluronic acid (cSHA) based gels in ACS procedures. Methods (ex-vivo study): 6 fresh human Eye-Bank eyes were used. A 15% Dextran solution was injected in the anterior chamber and the vitreous cavity, the corneal epithelium was removed by scraping, and the whole eye was immersed in 15% Dextran solution until corneal thickness reached a physiological value. The conjunctiva and tenon capsule were removed and the eye was mounted on a custom-made holder. Preoperative corneal topography was measured with a PAR corneal topography system. Five to eight 3mm-long linear equidistant anterior radial incisions starting from the limbus were performed in the sclera at 90% depth with a diamond blade. Postoperative corneal topography was measured. The files providing the pre and postoperative tangential curvature along meridians separated by 5 degrees were exported. The axial curvature along the 0 and 90-degree meridians before and after surgery were compared. Methods (in-vivo study): Of 24 rabbits, 4 were operated following Thornton's (90% depth incision) and 20 following Fukasaku's (100% depth) techniques (total peritomy, four 4mm long radial scleral incisions starting 0.5 mm from the limbus).