A Novel Biodendritic Adhesive for Sutureless Vitreous Surgeries: in vitro Studies of Wound Strength

Abstract

Abstract: : Purpose: An in vitro experiment to compare the immediate postoperative wound strength of porcine sclerotomy wounds closed with a novel biodendritic adhesive versus wounds closed with traditional suture Methods: All extraocular muscle, fat, subconjunctiva and tenon was removed from 16 porcine globes. The globes were cut in half, bisecting the cornea. Uvea, viteous and lens were removed from each hemiglobe and the corneal/scleral shells were individually mounted on a watertight artificial anterior chamber with two–port access. One port was used to infuse balanced salt solution and the other port was attached to a transducer to monitor pressure. Using a 19 guage NVR blade, a pars plana, full–thickness sclerotomy wound was made in each shell perpendicular to the limbus. 7 wounds were left unrepaired. 6 wounds were closed using a traditional 3–pass running configuration with 7–0 vicryl suture. 3 wounds were sealed using the biodendritic polymer hydrogel. For the hydrogel sealant treatment group, the adhesive solution was applied to the wound and cured in less than one minute.. BSS was then infused into the chamber at a rate of 5mL/hour. Infusion was continued until the wound leaked, at which point the pressure was noted. If the wound had not leaked before a pressure greater than 250mm/Hg, the experiment was terminated. Results: The untreated wounds leaked at an average pressure of 6 mm/Hg with a range of 3 – 11 mm/Hg. The sutured wounds leaked at an average pressure of 140 mm/Hg with a range of 90 – 250 mm/Hg. The wounds treated with the biodendritic adhesive all sustained pressures above 250 mm/Hg without leaking. Conclusions: In vitro porcine sclerotomy wounds treated with a novel biodendritic adhesive can sustain higher pressures than traditionally sutured wounds, without leaking. The ease of application and their biocompatibility may make these biodendrimers a useful alternative treatment for closing sclerotomy wounds. This experiment examined wound strength acutely. The next step will be to conduct in vivo experiments to compare wound healing in sutured wounds versus wounds sealed with the biodendrimer.

Keywords: vitreoretinal surgery • wound healing