Novel Visible-Light Curable Hydrogel for Closure of Sclerotomy Wounds in Pars Plana Vitrectomy

Abstract

Purpose: To evaluate the efficacy and stability of a visible-light curable hydrogel as a natural bioadhesive for closure of sclerotomy wounds. Methods: Sclerotomy wound closures were performed ex vivo on cadaveric human sclera and adult porcine eyeballs using a visible-light curable hydrogel, and the burst pressure was recorded. The scleral adhesivity of the hydrogel to human scleras (n = 12) under rotational shake was evaluated using anterior segment optical coherence tomography (OCT) and slitlamp biomicroscopy for 30 days. Results: The average burst pressure of sclerotomy wounds on human scleras closed with the visible-light curable hydrogel was 220.5 mm Hg (range, 75-400 [n = 10]), which was significantly higher compared with wounds closed with fibrin glue (133.7 mm Hg; range, 5-430 [n = 10]; P = .049) and no closures (20.5 mm Hg; range, 6.1-75.3 [n = 10]; P < .001). The average burst pressure of sclerotomy wounds in porcine eyeballs closed with the hydrogel was 234.9 mm Hg (range, 35-543 [n =10]), while the burst pressure in the control group was 25.4 mm Hg (range, 6.4-60.0 [n = 10]; P < .001). Regular slitlamp and anterior segment OCT examinations showed that the visible-light curable hydrogel was consistently attached to the human scleras during the 30 days of follow-up. Conclusions: This easily applied, novel visible-light curable hydrogel has potential use for closure of sclerotomy wounds after pediatric and adult pars plana vitrectomy and may reduce postoperative vitrectomy complications, including hypotony, endophthalmitis, and astigmatism.