Polyethylene Glycol-Based Synthetic Hydrogel Sealant for Filtration Bleb Leaks: An In Vivo and Histologic Study

Abstract

To evaluate the efficacy of polyethylene glycol (PEG)-based synthetic sealant for closing bleb leaks after glaucoma filtration surgery. Methods: Tube shunt surgery that included implantation of a 22-gauge indwelling catheter and intraoperative mitomycin C was performed in the left eyes of 11 New Zealand white rabbits. Seven days postoperatively, all filtration blebs were perforated with an 18-gauge needle to create a bleb hole. In six rabbits, the holes were covered with the sealant and irradiated with blue-green light for 60 seconds; in the five control rabbits, the holes were untreated. For 3 weeks after the tube shunt surgery, the eyes were checked for bleb leaks, and the intraocular pressure (IOP) was measured in both eyes. Finally, the operated eyes were enucleated for histologic examination. Results: The bleb leaks stopped in the eyes in which sealant was used and persisted in the other eyes. The sealant preserved the bleb function; the IOPs in these eyes were significantly (P < 0.05) lower than the right eyes that did not undergo surgery. Hematoxylin and eosin staining showed that the holes were closed and covered with conjunctival epithelial cells in the eyes in which sealant was applied; the holes were open in the control eyes. Immunohistochemical staining showed that the bleb holes in which the sealant was applied had fewer inflammatory cells. Conclusions: The PEG sealant has the potential to seal bleb leaks effectively. Translational Relevance: Application of the PEG sealant can be used as adjunct therapy for bleb leaks in glaucoma surgery.

Recent advances in adhesive materials used in the biomedical field: adhesive properties, mechanism, and applications

“…85 PEG is commonly used as a sealant to prevent leakage of liquid and air after surgery. 86,87 At present, the development of synthetic chemical adhesives mostly involves the modification of existing medical polymeric materials and combining them with different chemical substances to make them have more abundant functionalities. 88 However, when compared to existing chemical polymeric materials, biomaterial-derived materials have better properties and are suitable for application in biomedicine.…”

Glaucoma Treatment and Hydrogel: Current Insights and State of the Art

“…The majority of authors used hydrogels as a drug delivery system: they are implanted and provide for a localized and prolonged release of the drug they contain. Nagata et al [ 155 ], Xi et al [ 156 ], and Kojima et al [ 157 ] studied MMC-loaded hydrogels. They demonstrated that hydrogel causes a prolonged and controlled release of MMC, reducing its toxicity while simultaneously reducing the formation of fibrosis and ensuring a prolonged persistence of the bleb.…”

“…The leakage occurrence as a short-term complication after glaucoma surgery is becoming more frequent because of the increased application of mitomycin-C to delay wound healing [ 175 ]. Nagata et al proposed a PEG-Based Synthetic Hydrogel as a sealant after glaucoma surgery to inhibit bleb leaking [ 155 ]. On a rabbit model, they observed fewer lymphocytic infiltrations without inflammatory effects or conjunctival toxicity [ 155 ].…”

“…Nagata et al proposed a PEG-Based Synthetic Hydrogel as a sealant after glaucoma surgery to inhibit bleb leaking [ 155 ]. On a rabbit model, they observed fewer lymphocytic infiltrations without inflammatory effects or conjunctival toxicity [ 155 ].…”

Advances in biomaterials as a retinal patch for the repair of rhegmatogenous retinal detachment

“…( Osbun et al, 2012 ) In addition, in the field of ophthalmology, the PEG-based synthetic sealant could also act as an adhesion barrier to prevent leakage of filtration blebs and as an adhesive to close sclerotomies of PPV in rabbit eyes. ( Hoshi et al, 2016 ; Nagata et al, 2020 ).…”