Comparison of sutures and dendritic polymer adhesives for corneal laceration repair in an in vivo chicken model

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JAMA Ophthalmology

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Objective 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.

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