Comparison of Sutures and Dendritic Polymer Adhesives for Corneal Laceration Repair in an In Vivo Chicken Model

Abstract

To compare clinical and histologic healing of corneal lacerations repaired by sutures or a new polymeric adhesive.Methods: A central full-thickness 4.1-mm laceration was made in the right eyes of 60 white leghorn chickens. Half of the wounds were treated with biodendrimer polymer adhesive and half were closed with 3 interrupted 10-0 nylon sutures. Slitlamp examination was performed at 6 hours, daily for 7 days, and weekly for 21 days. Animals were humanely killed at days 1, 3, 7, and 28 for histologic examination to evaluate corneal healing.Results: Histologic observations on days 1, 3, and 7 showed glued wounds filled with fibrin, then hyperplastic epithelium, and subsequently scar tissue. Scarring was more prominent at day 7 in glued corneas; however, by day 28, sutured corneas exhibited more inflammation and scarring and much more irregular anterior corneal surfaces. Clinically, all glued corneas remained clear while nearly all sutured corneas had some degree of corneal scarring persisting through day 28. The procedure was about 5 times faster with sealant than with sutures. Conclusion:Corneal lacerations treated with adhesive heal favorably compared with sutures.Clinical Relevance: Biodendrimer adhesives represent a safe, effective, and technically easier alternative to traditional suture repair of corneal perforations.

Development of a novel in vivo corneal fibrosis model in the dog

“…Thus, this technique was inappropriate for the translational studies. Additionally, the use of a linear laceration and suture placement (Berdahl, Johnson et al 2009) was excluded as the presence of suture in the cornea was considered a possible confounding factor to the corneal wound healing process and an additional irritant to the dogs. Exposure to sulfur mustard can generate notable corneal fibrosis (Ruff et al 2013).…”

“…Current in vivo models of corneal fibrosis used to investigate anti-fibrotic agents utilize various methodologies such as sulfur mustard exposure, laceration and suture, and alkali burn (Berdahl et al 2009, Kadar et al 2013, Okada et al 2014). The alkali burn is easy to perform, does not require specialized equipment and presents minimal risk to those performing the procedure.…”

Analysis of inflammatory periimplant lesions during a 12-week period of undisturbed plaque accumulation—a comparison between flapless and flap surgery in the mini-pig

“…Berdahl et al tested nylon as suturing material in a chicken model and found inflammatory host responses to the material [22,23]. Sutures were removed 2 weeks post-insertion.…”

Tissue adhesives in ocular surgery

“…They have also demonstrated the use of the dendritic bio adhesive ([G1]-PGLSA-MA) 2 -PEG in numerous ocular applications including central corneal lacerations [143], clear corneal cataract incisions [144,145], flaps from LASIK surgery [146], scleral incisions [147] and 8-mm penetrating keratoplasties [148]. These in vitro studies tested the capability of this sealant to withstand high IOP (mean leakage pressure of 78.7 mmHg in lacerated cornea) [149].…”