Purpose:
There has been much recent interest in the use of adhesives in corneal surgery. Different approaches include the use of off–label use of FDA approved adhesives in the eye and development of new biological and chemical adhesives. We recently reported the use of an FDA approved light–cured dental adhesive to seal large corneal incisions ex–vivo. The purpose of this study is to report on the safe use of these materials in–vivo.
Methods:
A central 2.75 mm single plane linear corneal incision was created in the left eye of two groups of 7 New–Zealand white rabbits using a stainless steel keratome. A 1.0 mm side port incision was made and all wound closure and intraocular manipulations were made with the anterior chamber filled with filtered air. A single interrupted 10–0 nylon suture was used to approximate the wound in control eyes. Adhesive was used to seal the wound in experimental eyes as follows: The corneal surface was dried with a Weck–cell and then with a stream of sterile air. Adhesive primer was applied to the wound and allowed to dry for 30 seconds. The adhesive was then applied and polymerized with visible blue light for 30 seconds. Eyes were observed for 14 days and then examined for histopathology.
Results:
Watertight closure was obtained for all eyes. One eye in the suture group developed endophthalmitis. No eyes in the adhesive group developed endophthalmitis. The area of corneal opacity was larger in the adhesive group compared to the suture group. There was no clinical evidence of corneal melting or neovascularization in either group. There was no histopathologic evidence of abnormal inflammation or neovascularization in either group.
Conclusions:
Photopolymerized methacrylate adhesives appear to be safe and effective for in–vivo use in the rabbit cornea. Formulations specific for cornea use may provide improved optical quality, better adhesion and greater ease of use.
Keywords: trauma • cornea: clinical science • cataract