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R.R. Pfister, C.I. Sommers; Fibrin Sealant In Corneal Stem Cell Transplantion . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3930.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine if attachment of transplanted corneal epithelial stem cells to a deficient limbal niche can be improved with respect to stability of the transplant, inflammation, patient comfort, speed of operation, and reduction of complications. Methods: A total of 114 corneal stem cell reconstructions were performed in 95 patients from 1996 to 2003 using corneal stem cells primarily, amnion secondary, or both. Tisseel fibrin sealant was used as the only method of stem cell adhesion in 41 surgeries completed on 35 patients from 2000 to 2003. Results:Tisseel was used as the sole sealant for limbal reconstruction of epithelial stem cell transplants or amnion, of which 31 were primary pterygia, 4 were recurrent pterygia, while the remaining 6 were for various corneal stem cell deficient diseases. The fibrin sealant group showed one recurrence of the original disease process, but no complications. Sutures were used exclusively to affix the transplant to the recipient bed in 73 surgeries on 60 patients. Of these, 43 were primary pterygia, 19 recurrent pterygia and 11 miscellaneous deficiencies. There was one recurrence in the primary pterygia group, 2 recurrences in the recurrent group and none in the miscellaneous group. In the sutured group, 12 patients who presented with recurrent pterygia underwent 15 procedures, two of which recurred. After the completion of all surgical procedures all patients were free of pterygia. Miscellaneous deficiencies were included to demonstrate that corneal stem cell transplants can be safely and efficiently emplaced, using Tisseel, in a variety of conditions. In the sutured group, 10 of 11 cases were successful. Conclusions: For all corneal epithelial stem cell transplants, the reduction in inflammation, time in operation, postoperative pain, and recurrence rate or complications augurs for the more extensive use of Tisseel as a sealant.
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