Designing hydrogel adhesives for corneal wound repair

Abstract

Today, corneal wounds are repaired using nylon sutures. Yet there are a number of complications associated with suturing the cornea, and thus there is interest in an adhesive to replace or supplement sutures in the repair of corneal wounds. We are designing and evaluating corneal adhesives prepared from dendrimers -single molecular weight, highly branched polymers. We have explored two strategies to form these ocular adhesives. The first involves a photocrosslinking reaction and the second uses a peptide ligation reactions to couple the individual dendrimers together to from the adhesive. These adhesives were successfully used to repair corneal perforations, close the flap produced in a LASIK procedure, and secure a corneal transplant.

Characterization of silver nanoparticle-infused tissue adhesive for ophthalmic use

“…there is also the risk of needlestick injury to the surgeon or operating room personnel [1,6,7]. Suture areas can also be a site for infection and inflammation, which will lead to more complications and require additional treatment [6]. After operations, sutures and other fasteners have a tendency to loosen and possibly break, which entails extra treatment to fix these problems [1].…”

“…For ocular surgeries, suturing corneas often produces asymmetrical healing which results in a regular or an irregular astigmatism [6]. Treating this astigmatism would require more complicated surgery or a pair of corrective spectacles.…”

“…There are more than 12 million procedures done annually throughout the world that require the use of nylon sutures to close ocular wounds alone [6]. Since the eyes are commonly operated on, it is safe to say that there are many more millions of procedures that require wound closure.…”

“…Non-dissolvable mechanical fasteners require removal by the doctor. Trauma occurs and the opportunity for infection is present every time sutures are removed [6]. The need for patients to come back to the doctors to have mechanical fasteners removed and the chance that further complications might arise requiring subsequent treatments is highly undesirable and ultimately uneconomical.…”

“…Second, the adhesive should be able to polymerize in a moist environment within a reasonable curing time [1,2]. Third, the adhesive must be steadily metabolized by the surrounding tissue without generating an inflammatory response or be a site for infection [1,6]. Lastly, the adhesive should not deform the tissue and cause discomfort to the patient postoperatively [1,2].…”