Collagen-Based Fillers as Alternatives to Cyanoacrylate Glue for the Sealing of Large Corneal Perforations

Samarawickrama, Chameen; Samanta, Ayan; Liszka, Aneta; Buznyk, Oleksiy; Griffith, May; Allan, Bruce

doi:10.1097/ico.0000000000001459

Cited by 25 publications

(41 citation statements)

References 22 publications

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“…Alternative treatments for stromal defects are being explored that improve patient outcomes—since there are no technologies specifically approved for the filling and regeneration of stromal defects. Collagen, hyaluronic acid and gelatin based fillers are being investigated as alternatives to the commercially available treatments to provide better biointegration with host tissue 3 , 8 , 26 . These corneal fillers should be degradable and support corneal cell migration and proliferation.…”

Section: Discussionmentioning

confidence: 99%

“…Injuries and diseases of the cornea that lead to stromal defects are significant causes of disability, morbidity and vision loss worldwide 1 , 2 . In cases of corneal thinning or melt situations where perforation is imminent, off-label use of cyanoacrylate is employed to stabilize the cornea prior to a definitive but invasive corneal transplant 3 . However, cyanoacrylate glue creates an opaque, rough surface that provides no visual or regenerative benefits 4 .…”

Section: Introductionmentioning

confidence: 99%

“…In one study, dopamine hydrazone-crosslinked hyaluronic acid hydrogels were developed to enhance adhesivity to the corneal tissue and deliver limbal cells 8 . Samarawickrama et al showed that collagen-like peptide conjugated to PEG-maleimide was created to seal acute corneal perforations while promoting tissue regeneration 3 . Collagen is a particularly attractive biomaterial for ocular adhesives because it is the most abundant protein in mammals, is naturally present in corneal stroma and is the main structural protein in the extracellular environment 15 .…”

Section: Introductionmentioning

confidence: 99%

“…Collagen is a particularly attractive biomaterial for ocular adhesives because it is the most abundant protein in mammals, is naturally present in corneal stroma and is the main structural protein in the extracellular environment 15 . However, for collagen to be used in situ on a wounded corneal surface, the cytotoxicity of the chemistry being used to crosslink is a critical consideration 3 , 9 , 12 , 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

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In situ-forming collagen hydrogel crosslinked via multi-functional PEG as a matrix therapy for corneal defects

Fernandes-Cunha

Chen

et al. 2020

Sci Rep

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Visually significant corneal injuries and subsequent scarring collectively represent a major global human health challenge, affecting millions of people worldwide. Unfortunately, less than 2% of patients who could benefit from a sight-restoring corneal transplant have access to cadaveric donor corneal tissue. Thus, there is a critical need for new ways to repair corneal defects that drive proper epithelialization and stromal remodeling of the wounded area without the need for cadeveric donor corneas. Emerging therapies to replace the need for donor corneas include pre-formed biosynthetic buttons and in situ-forming matrices that strive to achieve the transparency, biocompatibility, patient comfort, and biointegration that is possible with native tissue. Herein, we report on the development of an in situ-forming hydrogel of collagen type I crosslinked via multi-functional polyethylene glycol (PEG)-N-hydroxysuccinimide (NHS) and characterize its biophysical properties and regenerative capacity both in vitro and in vivo. The hydrogels form under ambient conditions within minutes upon mixing without the need for an external catalyst or trigger such as light or heat, and their transparency, degradability, and stiffness are modulated as a function of number of PEG arms and concentration of PEG. In addition, in situ-forming PEG-collagen hydrogels support the migration and proliferation of corneal epithelial and stromal cells on their surface. In vivo studies in which the hydrogels were formed in situ over stromal keratectomy wounds without sutures showed that they supported multi-layered surface epithelialization. Overall, the in situ forming PEG-collagen hydrogels exhibited physical and biological properties desirable for a corneal stromal defect wound repair matrix that could be applied without the need for sutures or an external trigger such as a catalyst or light energy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

In situ-forming collagen hydrogel crosslinked via multi-functional PEG as a matrix therapy for corneal defects

Fernandes-Cunha

Chen

et al. 2020

Sci Rep

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“…[ 1 2 ] Presently available other alternatives have their own limitations such as amniotic membrane graft, tenon's patch graft, and conjunctival autograft lack adequate tensile strength, bio-engineered collagen-based fillers are costly, fragile, and scarcely available, Bowman's membrane transplant is associated with difficult donor dissection and unnecessary host manipulation and conventional corneal transplantation is restricted by scarcity of donor cornea and risk of transmission of infections, graft dislocation and graft rejection. [ 1 3 4 5 ]…”

mentioning

confidence: 99%

Emulsion polymer isocyanate-gluing: Autologous epithelial transplant with cyanoacrylate glue application for small corneal perforations

Bafna

Agarwal

Beniwal

et al. 2020

Indian J Ophthalmol

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Cyanoacrylate glue (CG) is a commonly employed modality for sealing small corneal perforations. Presently, we describe the technique of emulsion polymer isocyanate (EPI)-gluing, a modification of its application, and its results in nine eyes with noninfectious, nontraumatic sterile corneal perforation with size ≤3 mm. The method involves harvesting a small patch of autologous epithelium adjacent to the melt area with the help of 10% alcohol and transplanting to the site of melt with its basement membrane facing downwards. CG, loaded on the reverse side of Sinskey hook or Weck-Cel sponge, is instilled on this epithelium-melt site complex and withdrawn immediately following which a bandage contact lens is placed on the corneal surface. In our series of patients with nine eyes where EPI-gluing was undertaken, all eyes reported a healed corneal scar with spontaneously dislodged glue and no underlying vascularization at 3-months follow-up. EPI-gluing is an inexpensive and host-friendly technique for the treatment of small noninfectious corneal perforations particularly with iris tissue prolapse.

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Arrested Phase Separation Enables High‐Performance Keratoprostheses

Pan¹,

Zhang

Zhu

et al. 2023

Advanced Materials

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but donor cornea is scarce, [2] leading to delayed intervention and an increased probability of visual loss. [3] Furthermore, many patients cannot tolerate the donor cornea owing to repeated graft failure, autoimmune diseases, and ethical reservations. [4] To address these issues, effort has been devoted to exploring potential artificial corneas (keratoprostheses). [2] The prevailing keratoprosthesis approaches are either a pre-made synthetic prosthesis for restoring vision or a tissue-engineering scaffold for generating new tissue in situ. [5] Although tissue-engineered keratoprostheses can effectively regenerate the damaged cornea tissues, it is not free of ethical conundrums, and the immune rejection of the matrix's natural or artificial and donated cells can occur. [4b,6] In contrast, the completely synthetic cornea substitutes are merely constructed by synthetic materials, and thus overcome both sociocultural and policy difficulties in addition to avoiding viral invasion and immune rejection, [5,7,8] From the perspective of materials science, an optimal substrate for a synthetic cornea should combine vital features (Figure 1a) such as transparency for vision, processability for personalized geometry and size, [9] permeability for oxygen and nutrient transportation, and robustness to withstand the mechanical and environmental Corneal transplantation is impeded by donor shortages, immune rejection, and ethical reservations. Pre-made cornea prostheses (keratoprostheses) offer a proven option to alleviate these issues. Ideal keratoprostheses must possess optical clarity and mechanical robustness, but also high permeability, processability, and recyclability. Here, it is shown that rationally controlling the extent of arrested phase separation can lead to optimized multiscale structure that reconciles permeability and transparency, a previously conflicting goal by common pore-forming strategies. The process is simply accomplished by hydrothermally treating a dense and transparent hydrophobic association hydrogel. The examination of multiscale structure evolution during hydrothermal treatment reveals that the phase separation with upper miscibility gap evolves to confer time-dependent pore growth due to slow dynamics of polymer-rich phase which is close to vitrification. Such a process can render a combination of multiple desired properties that equal or surpass those of the state-of-the-art keratoprostheses. In vivo tests confirm that the keratoprosthesis can effectively repair corneal perforation and restore a transparent cornea with treatment outcomes akin to that of allo-keratoplasty. The keratoprosthesis is easy to access and convenient to carry, and thus would be an effective temporary substitute for a corneal allograft in emergency conditions.

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Collagen-Based Fillers as Alternatives to Cyanoacrylate Glue for the Sealing of Large Corneal Perforations

Cited by 25 publications

References 22 publications

In situ-forming collagen hydrogel crosslinked via multi-functional PEG as a matrix therapy for corneal defects

In situ-forming collagen hydrogel crosslinked via multi-functional PEG as a matrix therapy for corneal defects

Emulsion polymer isocyanate-gluing: Autologous epithelial transplant with cyanoacrylate glue application for small corneal perforations

Arrested Phase Separation Enables High‐Performance Keratoprostheses

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