Lasers in Surgery and Medicine

<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>To assess the efficacy and tolerability of Rose Bengal‐induced photochemical crosslinking (RB‐PCL) as an adjunct to suturing for corneal perforation repair in rabbits.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A 4.5 mm corneal wound was created in New Zealand White Rabbits (right eyes), followed by suturing and RB‐PCL treatment using 532 nm green light (0.6 W/cm²) and 0.01% RB photosensitizer. A control group received sutures alone. Healing was evaluated at Weeks 1, 2, and 4 using slit‐lamp biomicroscopy, anterior segment optical coherence tomography (AS‐OCT), RT‐PCR for α‐SMA gene expression, and immunofluorescence for myofibroblast activation. Histopathological changes were assessed via Hematoxylin and Eosin (H&amp;E) staining, and corneal endothelial cell counts were taken to assess cytotoxicity.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>RB‐PCL accelerated suture removal by Day 5, while sutures in the control group required longer retention. At Weeks 1 and 2, RB‐PCL demonstrated lower inflammation and reduced corneal opacity. By Weeks 2 and 4, α‐SMA expression was significantly reduced in the RB‐PCL group, indicating reduced myofibroblast activation and fibrosis. H&amp;E staining showed complete healing in the RB‐PCL group by Week 2, whereas the control group had incomplete repair. By Week 4, the RB‐PCL group had better fiber arrangement, while the control group showed persistent fibrosis. Immunofluorescence confirmed reduced α‐SMA expression in the RB‐PCL group. No retinal damage was observed, and endothelial cell counts were similar between groups, indicating RB‐PCL's tolerability.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>RB‐PCL improved corneal wound healing, reduced fibrosis and opacity, and allowed earlier suture removal without phototoxicity. These results suggest RB‐PCL is a promising adjunct for corneal perforation repair, enhancing both efficacy and tolerability.</jats:p></jats:sec>

publication_history

received

accepted

published

Innovative Method for Wound Debridement in Open Globe Injury

Indian Journal of Ophthalmology

Les Endophtalmies Post‐Traumatiques

Journal Français d'Ophtalmologie

Wound‐Related Complications and Clinical Outcomes Following Open Globe Injury Repair

Clinical & Experimental Ophthalmology

Effectiveness of Surgical Approach in the Management of Non‐Traumatic Corneal Perforations

Clinical & Experimental Optometry

The Removal of 10/0 Polyester (Mersilene) Sutures After Small Incision Congenital Cataract Surgery

European Journal of Ophthalmology

Designing Hydrogel Adhesives for Corneal Wound Repair

Biomaterials

Suture‐Related Complications After Congenital Cataract Surgery: Vicryl Versus Mersilene Sutures

Journal of Cataract and Refractive Surgery

Suture‐Related Complications Following Keratoplasty: A 5‐Year Retrospective Study

Cornea

The Use of Adhesive for the Closure of Corneal Perforations. Report of Two Cases

Archives of Ophthalmology

Ocular Adhesives: Design, Chemistry, Crosslinking Mechanisms, and Applications

In Situ Crosslinking of a Biomimetic Peptide‐PEG Hydrogel via Thermally Triggered Activation of Factor XIII

Tissue Adhesives for the Management of Corneal Perforations and Challenging Corneal Conditions

Clinical Ophthalmology

Fibrin Glue in Ophthalmology

Effect of Collagen Cross‐Linking in Collagen Corneal Shields on Ocular Drug Delivery

Journal of Ocular Pharmacology and Therapeutics

Release of Glutaraldehyde From an Albumin‐Glutaraldehyde Tissue Adhesive Causes Significant In Vitro and In Vivo Toxicity

Annals of Thoracic Surgery

Photosensitized Cross‐Linking of Tryptophan and Tyrosine Derivatives by Rose Bengal in Aqueous Solutions

Journal of Organic Chemistry

Enhancing Rose Bengal‐Photosensitized Protein Crosslinking in the Cornea

Investigative Opthalmology & Visual Science

Light‐Activated Tissue Bonding for Excisional Wound Closure: A Split‐Lesion Clinical Trial

British Journal of Dermatology

Photoactivated Rose Bengal Mitigates a Fibrotic Phenotype and Improves Cutaneous Wound Healing in Full‐Thickness Injuries

Wound Repair and Regeneration

Photochemical Repair of Vocal Fold Microflap Defects

Laryngoscope

Noninvasive Photochemical Sealing for Achilles Tendon Rupture by Combination of Upconversion Nanoparticles and Photochemical Tissue Bonding Technology

BioMed Research International

Photochemical Tissue Bonding Technique for Improving Healing of Hand Tendon Injury

Surgical innovation

Sensory Perturbations Using Suture and Sutureless Repair of Transected Median Nerve in Rats

Somatosensory & Motor Research

Microvascular Anastomosis Using a Photochemical Tissue Bonding Technique

Photochemical Keratodesmos for Bonding Corneal Incisions

Photochemical Keratodesmos as an Adjunct to Sutures for Bonding Penetrating Keratoplasty Corneal Incisions

Photochemical Cross‐Linking for Penetrating Corneal Wound Closure in Enucleated Porcine Eyes

Current Eye Research

Anatomy and Physiology of the Cornea

Change of Optical Intensity During Healing Process of Corneal Wound on Anterior Segment Optical Coherence Tomography

Scientific Reports

Basement Membrane Regeneration and TGF‐β1 Expression in Rabbits With Corneal Perforating Injury

Molecular Vision

Descemet's Membrane Modulation of Posterior Corneal Fibrosis

Investigative Ophthalmology & Visual Science

Descemet's Membrane Injury and Regeneration, and Posterior Corneal Fibrosis, in Rabbits

Experimental Eye Research

Temperature‐Controlled CO2 Laser Tissue Welding of Ocular Tissues

Survey of Ophthalmology

Use of the N‐Butyl Cyanoacrylate Adhesive and the Polyglactine Thread Suture for Corneal Rhaphy in Rabbit (Oryctolagus Cunicullus)

Journal of Veterinary Science

Topical Losartan Inhibition of Myofibroblast Generation in Rabbit Corneas With Acute Incisions

The Repair of Corneal and Scleral Lacerations

Seminars in Ophthalmology

Expression of Alpha‐Smooth Muscle (Alpha‐SM) Actin During Corneal Stromal Wound Healing

Phototoxicity to the Retina: Mechanisms of Damage

International Journal of Toxicology

Connection of Histological Corneal Endothelial Cell Count With Endothelial Cell Density Before Penetrating Keratoplasty

Graefe's Archive for Clinical and Experimental Ophthalmology

To assess the efficacy and tolerability of Rose Bengal-induced photochemical crosslinking (RB-PCL) as an adjunct to suturing for corneal perforation repair in rabbits.
A 4.5 mm corneal wound was created in New Zealand White Rabbits (right eyes), followed by suturing and RB-PCL treatment using 532 nm green light (0.6 W/cm²) and 0.01% RB photosensitizer. A control group received sutures alone. Healing was evaluated at Weeks 1, 2, and 4 using slit-lamp biomicroscopy, anterior segment optical coherence tomography (AS-OCT), RT-PCR for α-SMA gene expression, and immunofluorescence for myofibroblast activation. Histopathological changes were assessed via Hematoxylin and Eosin (H&E) staining, and corneal endothelial cell counts were taken to assess cytotoxicity.
RB-PCL accelerated suture removal by Day 5, while sutures in the control group required longer retention. At Weeks 1 and 2, RB-PCL demonstrated lower inflammation and reduced corneal opacity. By Weeks 2 and 4, α-SMA expression was significantly reduced in the RB-PCL group, indicating reduced myofibroblast activation and fibrosis. H&E staining showed complete healing in the RB-PCL group by Week 2, whereas the control group had incomplete repair. By Week 4, the RB-PCL group had better fiber arrangement, while the control group showed persistent fibrosis. Immunofluorescence confirmed reduced α-SMA expression in the RB-PCL group. No retinal damage was observed, and endothelial cell counts were similar between groups, indicating RB-PCL's tolerability.
RB-PCL improved corneal wound healing, reduced fibrosis and opacity, and allowed earlier suture removal without phototoxicity. These results suggest RB-PCL is a promising adjunct for corneal perforation repair, enhancing both efficacy and tolerability.

Photochemical Crosslinking as an Adjunct for Repairing Corneal Perforations in Rabbits.

Photochemical Crosslinking as an Adjunct for Repairing Corneal Perforations in Rabbits

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