A groundbreaking advancement in cataract surgery could significantly reduce complications and improve patient outcomes, thanks to a new “glowing” gel developed by scientists at Johns Hopkins University. This color-changing hydrogel has the potential to revolutionize one of the world’s most commonly performed surgeries, offering a simple yet highly effective solution to an ongoing challenge in ophthalmic care.
Cataracts, a condition in which the lens of the eye becomes clouded, lead to deteriorating vision and affect nearly everyone as they age. During cataract surgery, surgeons remove the cloudy lens and replace it with an artificial one. A critical part of the procedure involves injecting a clear hydrogel to maintain eye pressure and protect the cornea. However, incomplete removal of this gel can result in increased intraocular pressure, causing pain, complications, and even long-term vision loss.
To address this issue, Erick Rocher, a biomedical engineering graduate student, and Dr. Allen Eghrari, an associate professor of ophthalmology at the Wilmer Eye Institute, have developed an innovative solution. Their gel, which contains a fluorescent dye, turns bright green under blue light, allowing surgeons to confirm that all the gel has been removed at the end of the procedure. This simple color change ensures greater precision and enhances both the safety and efficiency of cataract surgery and other eye procedures.
The new hydrogel was featured on the cover of the Journal of Cataract & Refractive Surgery in October 2024. Rocher and Eghrari have also filed a provisional patent application for the innovation, which could significantly improve outcomes in eye surgeries.
“One of the challenges with the current gel is that it needs to be clear for the surgeon to operate effectively,” said Rocher, the paper’s first author. “As a result, it’s very easy for some gel to be left behind. Our new gel allows surgeons to quickly and accurately verify that all the gel has been removed, which was much harder to do before.”
Previously, surgeons had attempted to solve this problem by adding a staining agent to the gel, making it easier to spot under blue light. However, this often led to complications, as the dye could leak out and spread into the eye, making it difficult for surgeons to differentiate between the surgical gel and the dye.
Rocher and Eghrari’s gel improves on this by chemically bonding the fluorescent dye, fluorescein, to the polymer that forms the gel. The result is a clear gel during the surgery, which only glows green when exposed to blue light, allowing the surgeon to detect even the smallest amounts of residual gel. Additionally, modern digital microscopes can now highlight the gel without requiring a separate blue light, further improving visibility.
“The key advantage of this gel is that it combines high visibility with safety,” said Eghrari. “All the components are already in clinical use and have been proven to be safe for the eye. Moreover, the addition of the fluorescent dye does not significantly alter the gel’s viscosity, making it feel familiar to surgeons who use similar gels in their procedures.”
While the gel has shown promising results in preclinical testing, including studies in porcine models, Rocher and Eghrari note that human trials are still necessary to fully assess its safety and effectiveness. One of the next steps for the team will be scaling up the production of the gel for clinical use and optimizing the dye concentrations for best results.
Rocher, who has been working alongside Eghrari since his freshman year, is excited about the potential of the gel. “The possibilities for this gel are vast,” he said. “Sometimes the simplest innovations can have the greatest impact in the medical field, and we believe this is one of those cases.”
As the team moves toward clinical trials, the “glowing” gel could soon become a vital tool in cataract surgery, offering a simple yet powerful way to enhance surgical precision, reduce complications, and ultimately improve patient outcomes.
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