Development and Characterization of a Benchtop Corneal Puncture Injury Model

Eric J Snider,Peter R Edsall,Brian J Lund,Brandon Gross,Jorge M Acevedo,David O Zamora,Lauren E Cornell

doi:10.1038/s41598-020-61079-y

Abstract

During recent military operations, eye-related injuries have risen in frequency due to increased use of explosive weaponry which often result in corneal puncture injuries. These have one of the poorest visual outcomes for wounded soldiers, often resulting in blindness due to the large variations in injury shape, size, and severity. As a result, improved therapeutics are needed which can stabilize the injury site and promote wound healing. Unfortunately, current corneal puncture injury models are not capable of producing irregularly shaped, large, high-speed injuries as seen on the battlefield, making relevant therapeutic development challenging. Here, we present a benchtop corneal puncture injury model for use with enucleated eyes that utilizes a high-speed solenoid device suitable for creating military-relevant injuries. We first established system baselines and ocular performance metrics, standardizing the different aspects of the benchtop model to ensure consistent results and properly account for tissue variability. The benchtop model was evaluated with corneal puncture injury objects up to 4.2 mm in diameter which generated intraocular pressure levels exceeding 1500 mmHg. Overall, the created benchtop model provides an initial platform for better characterizing corneal puncture injuries as seen in a military relevant clinical setting and a realistic approach for assessing potential therapeutics.

Highlights

Eye-related injuries have risen in recent combat operations due to increased use of explosive weaponry
A second needle is inserted into the vitreous cavity and a catheter pressure transducer is drawn into the eye for improved intraocular pressure (IOP) readings (Fig. 1C)
In recent combat operations corneal puncture injuries resulted in poor visual outcomes for injured warfighters, often resulting in blindness

Summary

Introduction

Eye-related injuries have risen in recent combat operations due to increased use of explosive weaponry. CP wounds predominantly enter through the cornea and may damage the iris, lens, and even retina, depending on the speed, material, and trajectory of how the eye was punctured[3] These injuries are not mitigated until injured warfighters are evacuated back to an ophthalmic specialist for surgical repair. 53% of CP injured eyes retain IOFB upon injury and require evacuation to an ophthalmic specialist for surgical intervention[8]. In these cases, a rigid eye shield may or may not be used depending upon the location of the IOFB, in an effort to minimize disturbance to the damaged area. Military-relevant injuries are on average 3.5–5 mm in diameter, making them much larger than a scalpel injury[3,4,7]

Methods

Results

Conclusion