Abstract
Purpose :
Leaking corneal wounds after cataract surgery or trauma increase post-operative care and the risk of endophthalmitis. To seal penetrating corneal wounds we investigated a laser activated thin-film adhesive.
Methods :
The highest tolerable fluid pressure prior to wound leak (burst pressure) was used to assess corneal wound healing. 2mm central full thickness corneal wounds were created using a scalpel in right eyes of New Zealand albino rabbits, 5 eyes per group were included for each time-point. Control groups received a single interrupted 10-0 nylon suture, bandage contact lens (BCL) and tarsorrhaphy. The treatment group received manual debridement of surrounding epithelium, adhesive (4X6 mm diameter) application, BCL and tarsorrhaphy. The adhesive was activated using a GaAlAs near infrared (810nm) continuous wave laser at 125mW with a path of 1mm sec-1. Rabbits were euthanised after 0, 3, 24 & 72 hours. The globe was enucleated and corneoscleral rim dissected. Wound integrity testing was conducted using a customised system, that included a digital manometer. Burst pressure was the fluid pressure recorded at the first sign of Seidel positivity. Results were compared using two-samples t-test and significance set at 5%.
Results :
At 0-hours, treatment group (n=4) had a burst pressure of 62.3 (±17.4) mmHg, control group (n=5) 30.6 (±4.7) mmHg (p=0.0056). At 3-hours, treatment group (n=5) 207.4 (±121.6) mmHg vs control group (n=5) 10.6 (±6.8) mmHg (p=0.0069). At 24-hours, treatment group (n=5) 233.8 (±83.2) mmHg vs control group (n=5) 6.4 (±2.9) mmHg (p=0.0003). At 72-hours, treatment group (n=5) 229.0 (±120.1) mmHg vs control group (n=5) 12.4 (±6.6) mmHg (p=0.0038).
Conclusions :
The laser activated adhesive was able to seal full thickness corneal wounds in vivo and tolerate significantly higher burst pressure than sutures. The increase of burst pressure with time in the adhesive group compared to those closed with sutures suggests accelerated wound healing.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.