Synthesis and characterization of a chondroitin sulfate-polyethylene glycol corneal adhesive

Purpose: To describe the synthesis of a chondroitin sulfate-polyethylene glycol (CS-PEG) adhesive and characterize its physical and biological properties in vitro and in vivo. Setting: Johns Hopkins University and a research facility, Baltimore, Maryland, USA. Methods: Metabolic activity (WST-1 reagent) was used to evaluate the cytocompatibility of the adhesive with rabbit primary epithelial, stromal, and endothelial cells. Full-thickness corneal incisions (3.0 mm) in ex vivo porcine eyes were sealed with the adhesive, and burst pressure was evaluated to determine the effectiveness of the material in maintaining intraocular pressure (IOP). Finally, a partial-thickness incision was made in a swine cornea and then sealed using the adhesive. Two weeks postoperatively, both eyes were enucleated and examined grossly and histologically. Results: In vitro results showed cytocompatibility of the tissue adhesive with corneal cells and an ability to seal full-thickness corneal incisions exposed to IOPs of 200 mm Hg and higher. Histological evidence from in vivo data confirmed that the CS-PEG material is biodegradable, induces minimal inflammatory response, resists epithelial cell ingrowth, and does not induce scar formation. Conclusions: The new adhesive was effective in restoring IOP and withstanding pressures greater than 200 mm Hg after being applied to a full-thickness corneal incision. The adhesive material was biocompatible with the 3 types of cells found in corneal tissue. When the adhesive was implanted in a live swine model, no adverse side effects were observed.