The effect of a temperature-sensitive poloxamer-alginate-CaCl2 mixture after strabismus surgery in a rabbit model

Purpose To determine the efficacy of a temperature-sensitive poloxamer-alginate mixture in reducing adhesions after strabismus surgery in a rabbit model. Methods The superior rectus muscle was recessed in each of 36 eyes from 18 rabbits. One randomly assigned eye in each rabbit was treated with a poloxamer-alginate mixture (PA group); the other eye was treated with a subconjunctival injection of saline (control group). The adhesions between the superior rectus muscle, sclera, and conjunctiva were clinically evaluated by a masked observer at 1 day, 1 week, and 4 weeks after surgery. Inflammation was analyzed by hematoxylin and eosin staining and anti-CD11b staining. Late fibrosis was assessed by the Masson trichrome and α-smooth muscle actin staining. Adhesion, inflammation, and fibrosis were graded on a scale of 0-4. Results There was no significant between-group difference in the degree of adhesion at 1 day and 4 weeks after surgery. However, the degree of adhesion in the PA group was lower than that in the control group at postoperative week 1 ( P P  > 0.05). At postoperative week 4, inflammatory cell infiltration was reduced in the PA group ( P  = 0.046). A significant between-group difference in late fibrosis at postoperative week 4 was observed through the Masson trichrome ( P  = 0.024) and α-smooth muscle actin staining ( P  = 0.025). Conclusions The poloxamer-alginate mixture significantly decreased adhesion after strabismus surgery in a rabbit model. Additional studies are warranted to evaluate the use of this mixture in preventing postoperative adhesions.