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A Modified Chondroitin Sulfate Aldehyde Adhesive for Sealing Corneal Incisions

¹From The Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; and the ²Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland.

PURPOSE. To compare a modified chondroitin sulfate aldehyde adhesive with standard sutures for sealing corneal incisions.

METHODS. A keratome knife was used to create non–self-sealing, uniplanar, 3-mm, clear corneal incisions in enucleated rabbit eyes (n = 18). The wounds were sealed with either a chondroitin sulfate-aldehyde adhesive (n = 8), three 10-0 nylon sutures (n = 5), or one 10-0 nylon suture (n = 5). Wound stability was tested by filling the globes with balanced salt solution through an anterior chamber port and slowly increasing the IOP. The pressure changes were monitored with a digital manometer connected to the anterior chamber, and leak pressure was recorded for each eye. Confocal microscopy was performed on the glued eyes, to document the glue distribution along the wound.

RESULTS. The mean leak pressures in the single-suture and three-suture subgroups were 26.4 ± 6.0 and 44.3 ± 8.2 mm Hg (SD), respectively. The maximum IOP achieved in eyes that received the glue was 104.7 mm Hg with a mean of 101.4 ± 3.2 mm Hg. None of the eyes in which glue was used showed leakage. At confocal microscopy, the glue was distributed inside the wound edges as a homogeneous thin layer of a less dense signal than that of the stroma.

CONCLUSIONS. A novel chondroitin sulfate-aldehyde adhesive was shown to be effective ex vivo for sealing corneal incisions in rabbit eyes and was superior to sutures for this purpose.

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