Sodium Ferulate Attenuates Lidocaine-Induced Corneal Endothelial Impairment.

Guojian Jiang,Tingjun Fan

doi:10.1155/2018/4967318

Guojian Jiang, Tingjun Fan

Open Access

https://doi.org/10.1155/2018/4967318

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Abstract

The introduction of intracameral anaesthesia by injection of lidocaine has become popular in cataract surgery for its inherent potency, rapid onset, tissue penetration, and efficiency. However, intracameral lidocaine causes corneal thickening, opacification, and corneal endothelial cell loss. Herein, we investigated the effects of lidocaine combined with sodium ferulate, an antioxidant with antiapoptotic and anti-inflammatory properties, on lidocaine-induced damage of corneal endothelia with in vitro experiment of morphological changes and cell viability of cultured human corneal endothelial cells and in vivo investigation of corneal endothelial cell density and central corneal thickness of cat eyes. Our finding indicates that sodium ferulate from 25 to 200 mg/L significantly reduced 2 g/L lidocaine-induced toxicity to human corneal endothelial cells, and 50 mg/L sodium ferulate recovered the damaged human corneal endothelial cells to normal growth status. Furthermore, 100 mg/L sodium ferulate significantly inhibited lidocaine-induced corneal endothelial cell loss and corneal thickening in cat eyes. In conclusion, sodium ferulate protects human corneal endothelial cells from lidocaine-induced cytotoxicity and attenuates corneal endothelial cell loss and central corneal thickening of cat eyes after intracameral injection with lidocaine. It is likely that the antioxidant effect of sodium ferulate reduces the cytotoxic and inflammatory corneal reaction during intracameral anaesthesia.

Highlights

In cataract surgery, traditional retrobulbar and peribulbar anaesthesia is associated with dangerous complications such as globe perforation, retrobulbar hemorrhage, optic nerve trauma, brainstem anaesthesia, and extraocular muscle injury [1, 2]
To evaluate the effects of Sodium ferulate (SF) on LD-induced cytotoxicity, the Human corneal endothelial (HCE) cells at a logarithmic phase were divided into seven groups and treated with LD and SF dissolved in 10% Fetal bovine serum (FBS)-DMEM/F12 medium during which cell morphology was monitored for 24 h (Table 1)
Twenty-four hours after the medium was replaced with 10% FBS-DMEM/F12 containing 50 mg/L SF, cells in groups II–V recovered to normal morphology and formed confluent monolayers

Summary

Introduction

Traditional retrobulbar and peribulbar anaesthesia is associated with dangerous complications such as globe perforation, retrobulbar hemorrhage, optic nerve trauma, brainstem anaesthesia, and extraocular muscle injury [1, 2]. Intracameral anaesthesia acts directly on the iris and ciliary body, providing a significant decrease in pain and discomfort during intraocular procedures of cataract surgery [4]. Intracameral and topical anaesthesia when used in combination avoids the risks associated with retrobulbar and peribulbar blocks and provides another option for analgesia in ocular surgery [3,4,5,6,7]. Methods to reduce the cytotoxicity, especially to relieve oxidative stress of LD, are important to protect the corneal endothelium and guarantee clinically safe administration during cataract surgery. Both in vitro and in vivo experiments were designed to investigate the cytoprotective effects of SF on LD-induced corneal endothelial dysfunction and to determine if the clinical intracameral SF administration protects the corneal endothelia during anaesthesia

Materials and Methods

Results

Discussion

Conclusion

Conflicts of Interest