GelMA-Based Sealant: an Unconventional Surgical Approach to the Management of Selected Retinal Breaks

Rhegmatogenous retinal detachment (RRD) represents a sight-threatening condition that requires surgical intervention. While current surgical approaches are effective, they present notable limitations, including stringent postoperative positioning requirements and a steep surgical learning curve. In this study, we developed a gelatin methacryloyl (GelMA)-based synthetic hydrogel as a retinal break sealant, leveraging its unique tissue-adhesive properties. Our results demonstrated excellent ocular biocompatibility of GelMA, with maintained cell viability exceeding 90% across multiple retinal cell types. To optimize intraocular performance, we incorporated 15% (w/v) glucose into the GelMA hydrogel, achieving two critical improvements: (1) increased density (1.026 g/cm³ versus vitreous 1.005 g/cm³) for better tissue targeting, and (2) enhanced adhesive strength (25 kPa lap-shear strength), surpassing conventional fibrin glue (13.05 ± 2.15 kPa). In vivo experiments revealed that the hydrogel facilitated retinal reattachment in 75% of cases (8/12 eyes), significantly higher than the 16.7% reattachment rate in controls (2/12 eyes; p = 0.038). The biodegradable hydrogel promoted tissue repair over a 2-month period through coordinated retinal pigment epithelium and choroidal mechanisms, while maintaining >90% visible light transmittance for optimal optical clarity. These findings suggest that glucose-modified GelMA hydrogels offer a promising alternative approach to conventional RRD surgical management, addressing several key limitations of current techniques.