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Corneal Sealants in Clinical Use: A Systematic Review
Jackie Tan1, Leslie John Ray Foster1,2, Stephanie Louise Watson1
1Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney , Sydney, New South Wales, Australia.
Current Eye Research
|May 29, 2020
Summary
Clinical corneal sealants like ReSure® and OcuSeal® show promise for sealing full-thickness corneal wounds post-cataract surgery. However, high-level evidence remains limited for other corneal conditions.
Area of Science:
- Ophthalmology
- Biomaterials
- Wound Healing
Background:
- Full-thickness corneal wounds present a significant clinical challenge.
- Effective closure is crucial to prevent infection and vision loss.
- Corneal sealants offer a potential alternative or adjunct to traditional suturing methods.
Purpose of the Study:
- To systematically review the clinical application of corneal sealants for full-thickness corneal wound closure.
- To evaluate the efficacy and safety of available corneal sealant products.
Main Methods:
- A systematic literature search was performed across multiple databases (CENTRAL, Medline, PubMed, Embase, Scopus, mRCT, ICTRP).
- Keywords included 'cornea', 'full-thickness wound', 'sealant', and synonyms.
- Studies with evidence level 2 or higher (Oxford Centre for Evidence-based Medicine) were included.
Main Results:
- Seven studies were included, investigating ReSure®, OcuSeal®, human fibrin glue, and cyanoacrylates.
- ReSure® demonstrated superiority over sutures for sealing corneal incisions post-cataract surgery.
- OcuSeal® effectively sealed corneal wounds post-cataract surgery, preventing dye ingress.
- Human fibrin glue and cyanoacrylates were effective for small corneal perforations (<3 mm).
Conclusions:
- High-level evidence for corneal sealants is currently limited.
- ReSure® and OcuSeal® show efficacy in post-cataract surgery settings.
- Further data are needed for sealant use in complex corneal wounds, perforations from other etiologies.
- ReSure® exhibits good tolerability and safety based on post-approval registry data.
