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Novel laser-activated solder for sealing corneal wounds
Guillermo Noguera1, Woo-Seok Lee, Juan Castro-Combs
1Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Purpose:
To compare the effectiveness of a laser-activated biological tissue solder with that of standard sutures for sealing corneal incisions.
Methods:
Two keratome knives measuring either 3.0 mm or 2.85 mm were used to create a non-self-sealing peripheral oblique corneal wound (POCW) or a central perpendicular corneal wound (CPCW) in fresh rabbit cadaver eyes. Wounds were sealed with a solder strip (POCW; n = 5), a solder patch (CPCW; n = 5), or three interrupted nylon 10-0 sutures (n = 5). After the solder was placed on the wound, a diode laser was used to activate the solder, resulting in cross-linking to tissue. Wound stability was tested by a stepwise infusion of saline, and pressure changes were monitored with a digital manometer. Leaking pressure was recorded.
Results:
The pressurized mean baseline IOP in the intact globe was 131.13 mm Hg (SD, 4.66). Mean IOP after CPCW was 1.7 mm Hg (SD, 0.13); for POCW it was 3.62 mm Hg (SD, 3.09). For the CPCW group, the mean leaking pressure in the sutured eyes was 82.76 mm Hg (SD, 6.55), whereas in the solder patch it was 101.42 mm Hg (SD, 29.92; P = 0.2222). For the POCW group, the mean leaking pressure in the sutured eyes was 33.44 mm Hg (SD, 9.38), and the mean IOP achieved in the solder repaired eyes was 125.16 mm Hg (SD, 9.85; P = 0.0079).
Conclusions:
The tested laser-activated solder was as effective as sutures when used as a patch and superior to sutures for clear corneal incisions in this animal ex vivo model.
