Novel laser-activated solder for sealing corneal wounds.
OBJECTIVE
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.
Noguera
Guillermo
G
Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Lee
Woo-Seok
WS
Castro-Combs
Juan
J
Chuck
Roy S
RS
Soltz
Barbara
B
Soltz
Robert
R
Behrens
Ashley
A
D000818:Animals; D024042:Collagen Type I / Q000737:chemistry / Q000627:therapeutic use*; D003315:Cornea / Q000187:drug effects / Q000601:surgery; D065306:Corneal Injuries; D015807:Eye Injuries, Penetrating / Q000188:drug therapy* / Q000601:surgery; D007429:Intraocular Pressure; D007834:Lasers; D023421:Models, Animal; D011817:Rabbits; D012421:Rupture; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013536:Suture Techniques; D014945:Wound Healing / Q000187:drug effects*
D024042:Collagen Type I