Corneal Sealants in Clinical Use: A Systematic Review. (1st September 2020)

• Record Type: Journal Article
• Authors: Tan, Jackie; Foster, Leslie John Ray; Watson, Stephanie Louise
• Is Part Of: Current eye research. Volume 45:Number 9(2020)
• Page Start: 1025
• Page End: 1030
• Publication Date: 2020-09-01
• Subjects: Corneal laceration -- sealant -- glue -- adhesive; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Ophthalmology -- Periodicals; 573.88
• DOI: 10.1080/02713683.2020.1764052
• Languages: English
• ISSNs: 0271-3683

Abstract

ABSTRACT: Aim: To review the use of clinical corneal sealants for the closure of full thickness corneal wounds. Methods: A systematic review was conducted across CENTRAL, Medline, PubMed, Embase, Scopus, mRCT and ICTRP for the keywords of 'cornea', 'full-thickness wound', 'sealant' and their synonyms. Only evidence level 2 of higher as graded by Oxford Centre of Evidence-based Medicine were included for this review. Results: Seven studies were included; three randomized controlled trials investigated ReSure® sealant, 2 OcuSeal®, 1 human fibrin glue vs cyanoacrylate and 1 human fibrin glue as an adjunct to sutures vs sutures alone in penetrating keratoplasty. ReSure® was superior to suture for sealing leaking corneal incisions after cataract surgery despite provocation. ReSure® sealant has not been tested on complex full thickness corneal wounds, perforated ulcers or penetrating keratoplasty. OcuSeal® was also able to seal full thickness cornea wound post-cataract surgery to prevent ingress of Trypan blue dye. Human fibrin glue and cyanoacrylate were similarly effective in treating corneal perforations <3 mm of mixed etiologies. Conclusion: There are limited high-level evidence for corneal sealants. The currently available sealants with human data are ReSure®, OcuSeal®, human fibrin glue and cyanoacrylates. While ReSure® and OcuSeal® are effective post-cataract surgery, there are no data for perforations from other etiologies. Post-approval data from ReSure® registry report good tolerability and no apparent safety concerns.