Transcript Diapositiva 1

How to Seal Clear Cornea Incision After Cataract Surgery:
The Role of a Liquid Ocular Bandage
Matteo Piovella, MD & Barbara Kusa, MD
Centro di Microchirurgia Ambulatoriale
Monza
Italy
Dr Piovella has the following Financial interests or relationships to disclose as consultant:
Abbott Medical Optics INC
BD Medical Ophthalmic Systems
Slack INC
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How To Prepare OcuSeal ™
OcuSeal ™ is a synthetic hydrogel (85% water)
packaged as two components: powder and liquid separately
Hydrogel = cross-linked chemical with attached water molecules.
Solution must be used within 30 seconds!
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How To Prepare OcuSeal ™
BD Ophthalmic System
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OcuSeal ™ Histologic Study Conclusions
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Biocompatible
Re-epithelialisation: evident
Neovascularization: not evident
Degradation of OcuSeal™: evident
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OcuSeal ™ Chemistry
• 2 active components:
– PEG (ester) & PEI (water soluble amine)
• PEG + PEI  Cross-linked hydrogel (~30 secs)
• Hydrogel film is spread over patient’s wound
• Interacts with underlying tissues
• Forms a seal lasting 2-3 days.
– Tissue compliant
– Tissue adherent
– Elastic (gelatinous)
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Degradation of OcuSeal ™
• Hydrogel: applied on the external surface of the eye, it
naturally sloughs off.
• OcuSeal ™ within the wound: naturally degraded by
hydrolysis.
• Tissue healing occurs at roughly the same rate of hydrogel
degradation, hence the space is taken up by regenerated
tissue.
• Degradation by-products are water soluble, and therefore
are reabsorbed and excreted through the kidneys.
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OcuSeal™ Clinical Results
79 Eyes
Methods:
• At the end of cataract surgery, 79 cataract surgery patients received
OcuSeal ™ liquid bandage for corneal incision sealing ( BD Medical
Ophthalmic Systems) .
• 79 patients: 45 males – 34 females
• Mean age: 66.83 ± 11.32 yrs.
• Upon application, OcuSeal ™ liquid bandage cross-links within 30 seconds
and forms a smooth, soft and transparent protective barrier film over
corneal incisions.
Results:
• No patient discomfort , complications or adverse events were noted during
the first three months after application.
• During the learning curve, OcuSeal ™ was not applied correctly in 16 eyes.
• This was due to the fact that the product polymerises in 30 seconds and
application onto the cornea was not quick enough .
• The liquid bandage surplus disappears (slit lamp evaluation) in all patients
within 12 hours.
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Standard Clear Cornea Incision Vs OcuSeal ™ Use at Day 1 po
No OcuSeal
OcuSeal
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24 Hours After Surgery Patient Foreign Body Feeling
OcuSeal™ Use VS OcuSeal™ Unused
BCVA - 79 EYES
OcuSeal™ Use
79 Eyes
Without OcuSeal™
72 Eyes
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Patient Comfort (Foreign Body Feeling) Vs Tissue Adherent Time
Waiting Time Before Speculum Removal
(31 Eyes) 30 Secs
(29 Eyes) 45 Secs
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Why OcuSeal ™?
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Ease to use
May prevent bacterial inflow
Provides barrier to microbial infection
Long lasting action
Enough for the incision to heal
Degrades as tissue is regenerated
Promotes natural healing
Transparent
Comfortable for the patient
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OcuSeal ™ Application SurplusOcuSeal ™
Application Surplus Vs Recovery Time for
Smoothly Cornea Surfice – 11 Eyes
100%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Within 12 hrs
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Thank you for your attention !