Eyeworld

28 March 2018 EW NEWS & OPINION Research highlight by Liz Hillman EyeWorld Staff Writer quickly occlude an open globe inju- ry and avoid a drop in intraocular pressure that could lead to retinal detachment and vision loss. The compound was initially tested in research for the Argus II retinal prosthetic (Second Sight, Syl- mar, California), said Jack Whalen, PhD, assistant professor of ophthal- mology research, USC Roski Eye Institute, Los Angeles. With the DoD wanting people to think outside the box for treatments that could be administered in an "austere envi- ronment," Dr. Whalen and his team thought that the adhesive they were testing—which didn't quite work for attaching an electrode array to the retina—might be a simple-to-use, easily reversible way to seal globe injuries temporarily. Thus far, the sealant has been tested in open globe injuries in rabbits and is expected to move to clinical trials in humans by 2019. The original compound, poly(N-isopropylacrylamide), is a biocompatible hydrogel that at an elevated temperature becomes tacky, "like chewing gum," Dr. Whalen said. To make its state change faster at body temperature, the research- ers modified it by adding a mono- mer (butyl acrylate) to the original polymer. Once the co-monomer was developed, Dr. Whalen said they sought hands-on feedback from ophthalmologists and medics who were taking an ocular trauma course. hear about—this isn't glaucoma or cataracts—but it has a real quality of life impact. We're trying to figure out solutions to these problems, and they can have healthcare cost impacts as well," Dr. Whalen said. "I think it's always a challenge to have to consider there are life-chang- ing conditions that can happen to individuals, and as scientists, it's important that we consider that these smaller populations need to be addressed with whatever science is being developed." EW References 1. Weichel ED, et al. Combat ocular trauma visual outcomes during Operations Iraqi and Enduring Freedom. Ophthalmology. 2008;115:2235–45. 2. Department of Defense. Congressionally Directed Medical Research Programs. Vision. cdmrp.army.mil/vrp. Accessed Jan. 3, 2018. 3. Hilber D, et al. Eye injury surveillance in the U.S. Department of Defense, 1996–2005. Am J Prev Med. 2010;38:S78–85. 4. Vision Center of Excellence. Military Eye Trauma Statistics. vce.health.mil/ Vision-Knowledge/Vision-Loss-101/Military- Eye-Trauma-Statistics. Accessed Jan. 3, 2018. 5. Bayat N, et al. A reversible thermorespon- sive sealant for temporary closure of ocular trauma. Sci Transl Med. 2017;9. Editors' note: The University of South- ern California has submitted a patent application on the sealant technology. Contact information Whalen: jjwhalen@med.usc.edu Early research shows promise for hydrogel that becomes tacky at body temperature to occlude open globe injuries I n the United States Civil War, less than 1% of injuries were oc- ular. More than 100 years later after Operation Desert Storm in the Gulf War, that percentage was up to 13%, and it has remained relatively consistent in the more re- cent wars in Iraq and Afghanistan. 1–2 These injuries, most of which from 1996–2005 were caused by ordnance handling, enemy action, and fighting, can pose a threat to a patient's quality of life and result in cost burdens to the health system and days of productivity lost. 3–4 As such, the U.S. Department of Defense (DoD) established a vision research program in 2009 with the goal, in part, to better treat such war-related injuries. As part of that goal, a team out of the University of Southern California is in the process of creating a thermoresponsive, temporary sealant that could easily be administered in the field to close an open globe injury for a period of time until the patient can be seen for a surgical procedure. Published in the journal Science Translational Medicine, 5 researchers describe a compound that could According to the study, 100% of par- ticipants could successfully occlude an open globe injury in a pig eye by their second try after only watching a 10-minute video. "We were able to get a lot of feedback from end users," Dr. Wha- len said. "One thing we were able to show was that the testers were able to quickly use the technology with minimal training, and that was an angle for us, to make this user friendly." Though not yet tested in hu- mans, Dr. Whalen explained how the hydrogel would work. After it was applied in the globe injury, becoming tacky and preventing hypotony, the patient would be seen within a few days for surgery. To re- move the sealant, cold water would be applied, changing the state of the hydrogel to a more liquid form, allowing it to be aspirated from the eye. Dr. Whalen said they are con- ducting further research to establish how long the sealant can remain in the eye, safety and efficacy for human patients, and its potential application with other penetrating injuries. The group is also devel- oping other technologies for acute and temporary treatment of anterior segment trauma as well. "Ocular trauma is a unique challenge because it's a small population. This isn't like some of the bigger conditions that you'll Heat-activated, reversible, and temporary: New sealant in the works for ocular trauma A heat-activated, reversible sealant can quickly close open globe injuries until the patient can be seen for surgery. The sealant developed by researchers at the University of Southern California Roski Eye Institute was tested at an ocular trauma course at the Uniformed Services University of the Health Sciences where users provided valuable feedback. Source: Jack Whalen, PhD

• Blank Page
• Blank Page (1)