Sealing Penetrating Eye Injuries Using Photoactivated Bonding.

摘要

The overall goal of this research was to find a more efficient method of sealing complex corneal lacerations. The technology that we used to achieve this goal was to develop a light-activated technology in which amniotic membrane impregnated with Rose Bengal dye (a common photoactive vital dye used as a diagnostic tool for staining ocular surface abnormalities) was cross-linked to the surface of the cornea to achieve a water-tight seal. Fragments and debris propelled at high velocity by improvised explosive devices (IEDs) have increased the incidence of penetrating eye injuries in the current conflicts. At the height of this conflict, 29% of all evacuations from Iraq were due to ocular injuries.1 When an eye sustains a penetrating or perforating injury rapid closure with the formation of a water tight seal is critical to preventing infection and preventing surface epithelium from gaining entry into the eye. This stabilizes the eye until further reconstructive surgery can occur. Despite the fact that the normal human eye is only 24mm in diameter, the repair of this structure can take in excess of 4 hours in severe injuries, and involves the use of an operative microscope and placement of suture that are thinner than the human hair. This suturing requires specialized training. In complex lacerations, in which flat objects are propelled through the cornea, the lamella of the cornea can shred, making closure by suture impossible. In these cases surgical adjuncts are used to close the wound, none of which are approved by the FDA for this purpose. The most commonly used item is Cyanoacrylate glue (medical super glue). The cyanoacrylate glue can bind to the cornea surface creating a water-tight seal. Unfortunately, it sticks to the sutures and is difficult to remove. Additionally it is opaque preventing any further operative procedures.