Liquid ocular bandage adds safety, comfort to wound healing

After its two components are mixed and applied, the liquid bandage interacts with underlying tissue to form a seal that lasts 2 to 3 days.

Matteo Piovella

A liquid ocular bandage provides secure sealing of surgical incisions, thus preventing bacterial contamination, promoting healing processes and averting postoperative discomfort, according to one surgeon.

BD OcuSeal (BD Ophthalmic Systems) consists of a synthetic hydrogel that is applied directly to the ocular surface as a liquid, using a brush applicator.

“The hydrogel is activated by mixing two separate components. The final product is made 85% of water. Salts adjust the pH so that the product is very neutral upon contact with the eye,” Matteo Piovella, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.

How it works

The preparation requires mixing and shaking the two components before quickly applying the hydrogel to the eye.

“It is not as easy as it may seem, and it requires a learning curve,” Dr. Piovella said. “You are also fighting with time, because from the moment the components bond together, you have 30 seconds to apply the liquid to the eye.”

A clear corneal incision 1 day postop without OcuSeal (left) and with OcuSeal (right). Images: Piovella M

Once spread over the wound, the liquid bandage interacts with the underlying tissue to form a seal that lasts 2 to 3 days. Within this time interval, the seal provides a static environment for the natural tissue healing processes to occur and an effective barrier to contaminating organisms. Due to the transparency of the substance, vision is unaffected.

“Another major advantage of OcuSeal is patient comfort,” Dr. Piovella said.

Patient response

In a group of 63 cataract patients, the OcuSeal liquid bandage was applied unilaterally. No pain was reported in the eyes with OcuSeal, and foreign body sensation was reported in 15% of the cases.

“In the eyes without OcuSeal, foreign body sensation occurred in 70% of the cases,” Dr. Piovella said. “Results could be even better if we take into account that during the learning curve, OcuSeal was not applied correctly in eight eyes. The product polymerizes in 30 seconds, and we were not quick enough.”

Errors in the procedure, however, are easily repaired, with corneal irregularities disappearing within 24 hours. In the event that any of the substance is dispersed in the anterior chamber through the wound, it degrades naturally within 4 days.

“No damage is created, due to the high biocompatibility of the compound. Biocompatibility and histology tests have demonstrated that OcuSeal is nontoxic, non-irritant and non-mutagenic, and therefore completely safe,” Dr. Piovella said.

Potential applications of OcuSeal outside of cataract surgery include several other ocular procedures, such as refractive surgery, corneal abrasions, pterygium surgery and trabeculectomy. – by Michela Cimberle

• Matteo Piovella, MD, can be reached at Centro Microchirurgia Ambulatoriale, Via Donizetti 24, 20052 Monza, Italy; +39-03-938-9498; fax: +39-03-9230-0964; e-mail: piovella@piovella.com.