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J. Castro Combs, W. Camacho, P. Wittmann, S. A. Martins, A. Beherens; A Novel Reabsorbable Carbohydrate Based Tissue Adhesive for Sealing Clear Corneal Incisions. Invest. Ophthalmol. Vis. Sci. 2008;49(13):392.
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To compare the sealing capacity and toxicity of a novel reabsorbable tissue adhesive vs. standard sutures for clear corneal incisions.
A 2.75 mm keratome knife was used to create a non-self-sealing clear corneal incision parallel to the iris on the globes of 40 New Zealand white rabbits. Corneal wounds were sealed with either a reabsorbable carbohydrate based tissue adhesive (n=20), or two interrupted nylon 10-0 sutures (n=20). Two 27 gauge needles were inserted in the anterior chamber through the limbal area 180° away from each other. One needle was connected to an infusion system attached to a balanced saline solution back and the other was connected to a digital manometer. Wound stability was tested at 1, 3, 5, 7 and 10 days by a stepwise increase in intra ocular pressure (IOP). IOP changes were monitored and leaking pressures were recorded. Toxicity was assessed by measuring inflammatory cell infiltration in the wound area at all time points.
The mean maximum IOP achieved in the globes treated with tissue adhesive at 24 hours was 119.25 mmHg (SD 2.98), while in the group treated with sutures was 57 mmHg (SD 7.07). We found a statistically significant difference when the groups were compared (p= 0.028). The mean bursting pressure 72 h posterior to tissue adhesive application was 114.25 mmHg (SD 11.61). At the same time point, the mean bursting pressure in the suture treated group was 85 mmHg (SD 4.24). There was a statistically significantly different when both groups were compared at this time point (p= 0.028). The mean bursting pressure 5 days after sealant application was 119.25 mmHg (SD 2.98), and in the suture treated group was 115 mmHg (SD 7.07). We found a statistically significant difference when the two groups were compared (p= 0.028). There was not difference when both groups were compared at 7 and 10 d (p=0.65 and p=0.2 respectively). Finally, there was not difference in the amount of inflammatory cell infiltration when sutured corneas were compared to sealant treated corneas at any time point.
The tested reabsorbable tissue adhesive proved to be non toxic and superior to standard sutures when used for sealing clear corneal incisions in rabbit eyes in vivo. We did not observe difference between the two groups at the last two time points because by day 7 corneal incisions were already healed.
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