A Novel Photoactivated Biological Adhesive for Sealing Corneal Incisions

Abstract

Purpose: : To compare the effectiveness of a biological tissue adhesive vs. standard sutures for sealing corneal incisions.

Methods: : A keratome knife 3.0 mm was used to create a non–self–sealing clear corneal incision parallel to the iris in rabbit cadaveric eyes (n=10). Wounds were sealed with either a collagen–based tissue adhesive film (n=5), or three interrupted nylon10–0 sutures (n=5). After the adhesive was placed in the incision, a 1.45–µm wavelength diode laser with a spot size of 4.0 mm at 1.00 W was applied for 5–7 s to induce cross–linking between film collagen fibers and corneal tissue. Wound stability was tested by infusion of saline connected to the anterior chamber and slowly increasing the IOP by raising the height of a physiologic saline bag. Pressure changes were monitored with a digital manometer and leaking pressure was recorded.

Results: : The mean baseline IOP in the intact globe was 126.05 mmHg (SD 8.2), (range 112–135.7 mmHg) at a height of 200 cm above the eye level. The mean IOP immediately after corneal incision was 3.6 mmHg (SD 3.0), (range 0–9.1 mmHg). The mean leaking pressure in the suture group was 33.44 mmHg (SD 9.3), (range 25–45 mmHg), whereas in the adhesive was 125.16 mmHg (SD 9.8), (range 113.5–129.6 mmHg) (p=0.0079). None of the eyes of the adhesive group showed leakage at maximum pressure allowed by our system.

Conclusions: : The tested adhesive was shown to be effective ex vivo for sealing corneal incisions in rabbit eyes, and demonstrated to be superior to standard sutures in this model.

Keywords: wound healing • laser • small incision cataract surgery