chondroitin and Calcinosis

To determine the effect of intraoperative ophthalmic viscosurgical devices (OVDs) on late opacification of the Hydroview hydrogel intraocular lens (IOL) (Bausch & Lomb Surgical).. Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.. A retrospective study of 949 cases of Hydroview IOL implantations from February 1998 to September 2000 was conducted. Of the 949 implantations, 462 were performed by 1 surgeon (J.H.S.) using Viscoat (sodium chondroitin sulfate 4.0%-sodium hyaluronate 3.0%) and 487 were performed by a second surgeon (W.A.N.) using Biolon (sodium hyaluronate 1.0%). Surgical techniques were identical with the exception of surgeon OVD preference. The number of IOLs opacifying and requiring explantation was determined in each group.. Seventy-one Hydroview IOLs had surface calcification deposits that presented a mean of 39 months postoperatively. Twenty-two IOLs opacified sufficiently to warrant a recommendation of IOL explantation; 20 IOLs were explanted, and 2 surgeries were cancelled due to death or disability. In all cases of opacification, Viscoat had been used intraoperatively. This represented a 15.4% incidence of opacification in the Viscoat group, with 31.0% cases severe enough to warrant a recommendation of explantation.. The results suggest that the intraoperative use of Viscoat has a facilitating role in the development of late calcification and opacification of the Hydroview IOL.

Topics: Adult; Aged; Aged, 80 and over; Calcinosis; Chondroitin; Chondroitin Sulfates; Device Removal; Drug Combinations; Female; Humans; Hyaluronic Acid; Hydrogel, Polyethylene Glycol Dimethacrylate; Incidence; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Middle Aged; Prosthesis Failure; Reoperation; Retrospective Studies

A patient developed an acute onset of pseudophakic bullous keratopathy and a diffuse, gray, subepithelial corneal deposit ten days following surgery during which sodium chondroitin sulfate was used. The deposit, identified histologically as calcium, was noted throughout Bowman's layer. The absence of chronic pathologic features in the posterior cornea eliminated Fuchs' endothelial dystrophy as the cause of the acute corneal decompensation. This histopathologic confirmation of calcium deposition with one formulation of chondroitin sulfate, combined with similar conclusions from previous case reports, stimulated the reformulation of the product, which has been shown to be useful in clinical practice.

Topics: Aged; Calcinosis; Cataract Extraction; Chondroitin; Cornea; Corneal Diseases; Corneal Opacity; Corneal Transplantation; Female; Humans; Lenses, Intraocular; Postoperative Complications

Band keratopathy developed rapidly in two patients following uneventful phacoemulsification and intraocular lens implantation using BSS Plus (balanced salt solution enriched with glutathione, bicarbonate, and glucose) infusion and Viscoat (chondroitin sulfate-sodium hyaluronate), which was left in the anterior chamber at the conclusion of the procedure. Histopathologic evaluation of corneal tissue obtained from one patient at the time of edetic acid chelation revealed histochemical findings consistent with anterior stromal calcification. To investigate a possible relationship between Viscoat and the rapid onset of band keratopathy, Viscoat formulated with varying concentrations of phosphate buffer was injected intracamerally into 42 rabbit eyes. Within 48 hours, clinically obvious corneal opacification developed in nine (47%) of 19 eyes injected with the commercial preparation of Viscoat. Also, similar opacification developed in ten (77%) of 13 eyes that received Viscoat formulated with twice the phosphate concentration of the commercial preparation. Band keratopathy did not develop any of ten eyes that received Viscoat with one fourth the commercial phosphate concentration. In selected opacified corneas, the presence of phosphorus in the subepithelial and posterior corneal stroma was confirmed by histochemical stains and energy-dispersive x-ray analysis.

Topics: Aged; Aged, 80 and over; Animals; Anterior Chamber; Calcinosis; Chondroitin; Chondroitin Sulfates; Corneal Diseases; Drug Combinations; Female; Humans; Hyaluronic Acid; Instillation, Drug; Male; Rabbits

Topics: Calcinosis; Cataract Extraction; Chondroitin; Cornea; Corneal Diseases; Epithelium; Humans; Lenses, Intraocular; Postoperative Complications

Topics: Acetates; Animals; Calcinosis; Calcium Phosphates; Capillaries; Capillary Permeability; Chondroitin; Creatinine; Cytoplasmic Granules; Heparin; Histamine; Histocytochemistry; Hyaluronic Acid; Injections, Intravenous; Injections, Subcutaneous; Lead; Male; Mast Cells; Mice; Permeability; Phosphates; Polymyxins; Serotonin; Sulfates; Vasodilator Agents

Topics: Bone and Bones; Calcinosis; Child; Chondroitin; Chromatography; Epiphyses; Femur; Glycosaminoglycans; Humans; Male; Medulla Oblongata; Osteopetrosis; Papain; Sulfates

Topics: Animals; Aorta, Thoracic; Aortic Aneurysm; Arteriosclerosis; Calcinosis; Cardiac Catheterization; Chondroitin; Collagen; Dilatation; Glycosaminoglycans; Histocytochemistry; Hyaluronic Acid; Male; Necrosis; Permeability; Rabbits; Serum Albumin, Radio-Iodinated; Stress, Mechanical; Sulfates; Sulfur Isotopes; Wound Healing; Wounds and Injuries

Topics: Animals; Apatites; Calcinosis; Chondroitin; Drug Antagonism; Epiphyses; In Vitro Techniques; Lanthanum; Rats; Rickets; Stilbamidines; Stimulation, Chemical; Tibia; X-Ray Diffraction; Yttrium

Topics: Adult; Age Factors; Aged; Anesthesia, General; Biopsy; Bone and Bones; Calcinosis; Cervical Vertebrae; Chondroitin; Chromatography, Ion Exchange; Contrast Media; Diabetes Complications; Female; Femur Head; Glycosaminoglycans; Hexosamines; Humans; Humerus; Hyaluronic Acid; Immobilization; Joint Diseases; Male; Manipulation, Orthopedic; Microscopy; Microscopy, Electron; Middle Aged; Movement; Radiography; Seasons; Sex Factors; Shoulder; Shoulder Injuries; Shoulder Joint; Strontium Isotopes; Synovial Fluid

Topics: Animals; Aorta; Calcinosis; Calciphylaxis; Chondroitin; Ergocalciferols; Glucuronates; Glycosaminoglycans; Iron; Rats

Topics: Animals; Calcification, Physiologic; Calcinosis; Calcium; Chondroitin; Depression, Chemical; Epiphyses; Glycosaminoglycans; Heparin; In Vitro Techniques; Lanthanum; Rats; Rickets; Skin; Skin Diseases; Templates, Genetic; Tibia

Topics: Analysis of Variance; Animals; Aorta; Blood Sedimentation; Body Weight; Calcinosis; Cholesterol; Chondroitin; Coronary Vessels; Ergocalciferols; Female; Flavonoids; Hematocrit; Necrosis; Nephrocalcinosis; Rats; Rutin

Topics: Calcification, Physiologic; Calcinosis; Chondroitin; Chondroitin Sulfates; Humans