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P. Szurman, M. Warga, S. Grisanti, R.T. Kaczmarek, J.M. Rohrbach, K.U. Bartz–Schmidt; Sutureless amniotic membrane fixation with fibrin glue for ocular surface reconstruction . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3917.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate a new method for minimally invasive fixation of amnion membrane for ocular surface reconstruction. Methods: In a first step, the ideal concentration and ratio of fibrinogen and thrombin were determined. After preparation of human amniotic membrane discs using a 7 mm trephine, different dilutions of a commercially available fibrin glue (Tissue Col©) were tested to affix the specimen on porcine cadaver eyes. Fourteen different modes of application were investigated. The samples were evaluated for handling, manipulation time until cross–linking, adhesive properties and histological pattern. For in–vivo experiments, twelve pigmented rabbits were operated with amnion membrane transplantation divided into two groups. In six eyes, the amnion membrane was fixated using the fibrin glue technique, in the other six eyes the membrane was conventionally sutured with 10.0 nylon. The rabbits were sacrificed after one week and the eyes were processed for histology. Results: Convincing adhesive properties with a sufficient manipulation time of 60 s were achieved using a concentration of 100 mg/ml fibrinogen and 20 IE thrombin. A two–step technique using amnion membrane immersion in undiluted fibrin solution, mild cross–linking with 20 IE thrombin on the cornea and final curing with undiluted thrombin showed the best results. This technique was applied in rabbit eyes and disclosed a stable fixation during the follow–up time. Epithelialisation was complete after three days in both groups. Histology showed an attached and epithialised transplant. Conclusions: This two–step technique described allows for easy and sutureless corneal fixation of amniotic membrane with sufficient manipulation time and without shrinkage of the transplant.
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