title: Evaluation of a new bioadhesive copolymer (ADAL) to seal corneal incisions.
abstract: OBJECTIVE
  To evaluate the efficacy and clinical tolerance of a new acrylic copolymer tissue adhesive, ADAL, in corneal surgery.
  
  
  METHODS
  Corneal incisions were performed on 24 New Zealand albino rabbits. The incision was either sealed with ADAL bioadhesive, hydrated with balanced salt solution, or closed with 10-0 nylon surgical sutures. The incisions underwent weekly tensile strength testing and clinical, histopathologic, and confocal microscopy evaluations.
  
  
  RESULTS
  Clinical evaluation revealed good sealing and no incision leakage in any group. There was no anterior chamber reaction in any case. Compared with the hydrated group, there was somewhat more incisional vascularization and localized corneal opacity in the ADAL group, but there were no cases of severe corneal opacity or neovascularization. On histologic analysis, a slightly larger inflammatory reaction was noted in the ADAL group compared with the hydrated group. Tensile strength during the first week was statistically significantly greater in the ADAL group (2.93 Newtons) than in the control groups (1.40 Newtons, hydrated group; 1.43 Newtons, sutured group) (P < 0.001). Confocal microscopy study revealed a unique dendritic keratocyte shape and structure resembling shiny crystalline particles after disappearance of the adhesive from the cornea.
  
  
  CONCLUSIONS
  Corneal surgical incisions sealed with ADAL adhesive have superior tensile strength in the first postoperative week compared with incisions closed with sutures or hydrated with salt solution. Thereafter, findings in both groups became similar. The use of ADAL adhesive was not associated with any deleterious effects during the corneal incision-healing process compared with hydration or sutures.
authors.affiliation: Refractive Surgery and Cornea Department, Instituto Oftalmologico de Alicante, Miguel Hernandez University, School of Medicine, Alicante, Spain. jlalio@oftalio.com
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: M Emilia
authors.initials: ME
authors.lastname: Mulet
authors.forename: Daniel
authors.initials: D
authors.lastname: Cotlear
authors.forename: Yenis
authors.initials: Y
authors.lastname: Molina
authors.forename: Israel
authors.initials: I
authors.lastname: Kremer
authors.forename: José M
authors.initials: JM
authors.lastname: Martin
mesh_terms: D000179:Acrylates / Q000627:therapeutic use* / Q000633:toxicity; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use* / Q000633:toxicity; D003228:Conjunctiva / Q000098:blood supply; D003315:Cornea / Q000601:surgery*; D016510:Corneal Neovascularization / Q000139:chemically induced; D004353:Drug Evaluation, Preclinical; D006940:Hyperemia / Q000139:chemically induced; D018613:Microscopy, Confocal; D011817:Rabbits; D013718:Tensile Strength; D014014:Tissue Adhesives / Q000627:therapeutic use* / Q000633:toxicity; D014945:Wound Healing / Q000187:drug effects*
chemical_list: C481620:ADAL-2; D000179:Acrylates; D001672:Biocompatible Materials; D014014:Tissue Adhesives