Effect on Gel Formation Time of Adding Topical Ophthalmic Medications to ReSure Sealant, an In Situ Hydrogel.

PURPOSE: The purpose of this study was to describe the gel formation times of ReSure(®) Sealant, an in situ hydrogel approved to seal cataract surgery incisions, when commercially available topical medications are mixed with the sealant.

METHODS: In this experimental laboratory study, the commercial product, ReSure Sealant, was used as per the product insert. Two drops of diluent were mixed with the polymer and time to gel formation was measured. Following this, various commercial antibiotic, nonsteroidal anti-inflammatory drug and steroid drops were used in substitution of one of the drops of the diluent. Combinations of 2 medications were also tested. Each condition was performed in triplicate and the mean gel time was calculated.

RESULTS: The addition of bromfenac slightly reduced mean gel time from 19 s (ReSure alone) to 13 s. All other medications, including moxifloxacin, gatifloxacin, ofloxacin, ciprofloxacin, loteprednol etabonate, prednisolone acetate, dexamethasone, ketorolac, and nepafenac, increased mean gel time, ranging from 49 s to >120 s. The addition of bromfenac to moxifloxacin, ofloxacin, or gatifloxacin reduced their mean gel times from ≥105 s to 18-29 s.

CONCLUSIONS: Certain medications, specifically bromfenac, may not substantially alter time to gel formation of ReSure Sealant when added to the hydrogel. In fact, bromfenac added to moxifloxacin, ofloxacin, or gatifloxacin reduced gel formation time to acceptable levels. All other medications and combinations of medications added to ReSure Sealant produced unacceptably long gel times to be used routinely. Clinical studies may be considered based on these results to assess the safety and efficacy of this strategy.