A New Model of Extraocular Muscle Fibrosis by Thermal Cauterization in the Rats

Min Gyu Choi; Nam Ju Moon

doi:10.3341/jkos.2018.59.5.478

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Choi and Moon: A New Model of Extraocular Muscle Fibrosis by Thermal Cauterization in the Rats

Original Article

J Korean Ophthalmol Soc 2018;59(5):478-483.

Published online: 25 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.5.478

A New Model of Extraocular Muscle Fibrosis by Thermal Cauterization in the Rats

Min Gyu Choi, MD, Nam Ju Moon, MD, PhD

Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea

Address reprint requests to Nam Ju Moon, MD, PhD Department of Ophthalmology, Chung-Ang University Hospital, #102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea Tel: 82-2-6299-1666, Fax: 82-2-825-1666 E-mail: njmoon@cau.ac.kr

Received 14 December 2017 Revised 16 February 2018 Accepted 23 April 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effect of cauterization on extraocular muscle (EOM) fibrosis in rats, and to develop a novel EOM fibrosis model.

Methods

Twenty-four eyes of 12 Sprague Dawley rats were assigned randomly to two groups. We exposed the superior rectus muscle (SRM) and performed thermal injury 2 mm behind the insertion site of the SRM using a cautery device in the experimental group. The thermal injuries were performed twice for 1 second, for a total of 2 seconds. In the control group, the same procedures except the thermal injury were performed. Two weeks after surgery, all eyes were enucleated and stained with hematoxylin and eosin (H&E) and Masson's trichrome (MT).

Results

Staining with H&E and MT showed that thermal injury significantly increased inflammation and fibrosis in the experimental group (p = 0.002, p < 0.001, respectively).

Conclusions

Thermal injury using cauterization effectively induced fibrosis of EOM in the rat model. This simple model was effective in inducing fibrosis of SRM and will be useful for studying postoperative fibrosis after strabismus surgery.

Keywords: Cauterization, Extraocular muscle, Fibrosis, Rat, Thermal injury

References

1. Mora JS, Sprunger DT, Helveston EM, Evan AP. Intraoperative sponge 5-fluorouracil to reduce postoperative scarring in abdominal surgery. J AAPOS. 1997; 1:92–7.

2. Cruz OA. Evaluation of mitomycin to limit postoperative abdominal in strabismus surgery. J Pediatr Ophthalmol Strabismus. 1996; 33:89–92.

3. Minguini N, Monteiro de Carvalho KM, Akaishi PM, De Luca IM. Histologic effect of mitomycin C on strabismus surgery in the rabbit. Invest Ophthalmol Vis Sci. 2000; 41:3399–401.

4. Jung KI, Choi JS, Kim HK, Shin SY. Effects of an abdominal growth factor-beta agent (pirfenidone) on strabismus abdominal in rabbits. Curr Eye Res. 2012; 37:770–6.

5. Ozkan SB, Kir E, Culhaci N, Dayanir V. The effect of Seprafilm on adhesions in strabismus surgery-an experimental study. J AAPOS. 2004; 8:46–9.

6. de Carvalho LE, Alves MR, da Silva MA, Gaal Vadas MF. Experimental strabismus surgery using triamcinolone: outcomes and effects on inflammatory response. Arq Bras Oftalmol. 2007; 70:209–15.

7. Frangouli O, Adams GG. The use of amniotic membrane for the management of fibrosis in complex strabismus surgery. Strabismus. 2013; 21:13–22.

8. Kirsch D, Lowen MS, Fialho Cronemberger MF, Sato EH. Amniotic membrane for reducing the formation of adhesions in strabismus surgery: experimental study in rabbits. J Pediatr Ophthalmol Strabismus. 2014; 51:341–7.

9. Kassem RR, Abdel-Hamid MA, Khodeir MM. Effect of lyophi-lized amniotic membrane on the development of adhesions and abdominal after extraocular muscle surgery in rabbits. Curr Eye Res. 2011; 36:1020–7.

10. Lee MJ, Jin SE, Kim CK, et al. Effect of slow-releasing all-transretinoic acid in bioabsorbable polymer on delayed adjustable strabismus surgery in a rabbit model. Am J Ophthalmol. 2009; 148:566–72.

11. Demirel S, Atilla H, Okcu Heper A, Erkam N. Effects of amniotic membrane on wound healing and adhesions in experimental abdominal surgery. Eur J Ophthalmol. 2009; 19:899–904.

12. Cai EZ, Ang CH, Raju A, et al. Creation of consistent burn wounds: a rat model. Arch Plast Surg. 2014; 41:317–24.

13. Yaacobi Y, Hamed LM, Kaul KS, Fanous MM. Reduction of abdominal adhesions secondary to strabismus surgery in rabbits. Ophthalmic Surg. 1992; 23:123–8.

14. Velnar T, Bailey T, Smrkolj V. The wound healing process: an abdominal of the cellular and molecular mechanisms. J Int Med Res. 2009; 37:1528–42.

15. Vindinský B, Gál P, Toporcer T, et al. Histological study of the first seven days of skin wound healing in rats. Acta Vet Brno. 2006; 75:197–202.

16. Tarran S, Langlois NE, Dziewulski P, Sztynda T. Using the abdominal cell infiltrate to estimate the age of human burn wounds: A review and immunohistochemical study. Med Sci Law. 2006; 46:115–26.

17. Gravante G, Palmieri MB, Delogu D, Montone A. Apoptotic cells in cutaneous adnexa of burned patients. Burns. 2007; 33:129–30.

Figure 1.

Demonstration of the operation procedure. (A) Exposure of the upper conjunctiva. (B) Subconjunctival injection of 0.1 mL of normal saline. (C) Limbal peritomy from 10 to 2 o'clock. (D) Isolation of the superior rectus muscle. (E) Thermal injury on superior rectus muscle (black arrow).

Figure 2.

Photomicrographs showing inflammation of the superior rectus muscle two weeks after surgery in the rat model (hematoxylin and eosin staining, ×100). (A) Grade 0. (B) Grade 1. (C) Grade 2. (D) Grade 3.

Figure 3.

Bar graphs showing the degree of inflammation of superior rectus muscle two weeks after surgery. The grade of inflammation was statistically different between control and cauterization group (p = 0.002).

Figure 4.

Photomicrographs showing fibrosis of the superior rectus muscle two weeks after surgery in the rat model (Masson's trichrome staining, ×100). (A) Grade 0. (B) Grade 1. (C) Grade 2. (D) Grade 3. (E) Grade 4.

Figure 5.

Bar graphs showing the degree of fibrosis of superior rectus muscle two weeks after surgery. The grade of fibrosis was statistically different between control and cauterization group (p ≤ 0.001).

Table 1.

Detailed description of grade of inflammation and fibrosis according to photomicrographic findings

	Grades	Descriptions
Inflammation	0	Inflammatory infiltrate absent
	1	Mild inflammatory infiltrate (presence of lymphocytes)
	2	Moderate inflammatory infiltrate (presence of lymphocytes, plasmocytes, and scattered macrophages)
	3	Intense inflammatory infiltrate (presence of lymphocytes, plasmocytes, macrophages, and neutrophils)
Fibrosis	0	No fibrosis
	1	Mild perimuscular fibrotic reaction (stained collagen was detectable only in thin bands immediately adjacent to the muscle)
	2	Easily detected thick bands
	3	Well-developed, dense bands of collagen
	4	A severe fibrotic response replacing large areas

Table 2.

The grades of inflammation and fibrosis in each group two weeks after surgery

	Control^*	Cauterization^*	p-value
Inflammation	0.75 ± 0.62	1.83 ± 0.52	0.002^†
Fibrosis	0.83 ± 0.58	2.42 ± 0.90	<0.001^†

Values are presented as mean ± SD unless otherwise indicated.

^* Standard deviation

^† Kruskal-Wallis test.

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