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Rafael A. Bueno-Garcia, Mariana Martinez-Castellanos; Experience in the use of Fibrin Glue in Vitreoretinal Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):554.
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The aim of this study is to present our experience in the use of fibrin glue in vitreoretinal surgery
We included 178 eyes of 162 patients who underwent a vitreoretinal surgery during the period of may to november 2010, the preoperative diagnoses where as following: proliferative diabetic retinopathy 104 eyes, regmatogenus retinal detachment 18 eyes, macular hole 12 patients, epiretinal membrane 8, luxation of cataratous nucleous and cortex 8, intraocular lens luxation 6, penetrating trauma 4, silicone extraction 4, phaco+ IOL+Vitrectomy+Ahmed valve implant 2, vitreous biopsy 2. Fifty two eyes requiered use of silicone oil, 32 --5000cs, 18-- 1000cs and otwo heavy silicone. 64 eyes has a gas tamponade and 62 saline solution. 172 patients underwent 23 gauge vitrectomy, four patients 29 gauge and two 25 gauge, all of the procedures were performed with accurus surgical system (Alcon). We used the fibrin glue in all of the wounds, sclerotomies (all 3 different calibers), scleral wound for IOL extraction, conjunctiva peritomy for bucle, conjunctiva in Ahmed valve implant.
We did not used any suture in all 178 eyes in the different procedures, there was no leakage in sclerotomies in immediate postoperative or after, we found no inflammatory reaction, infection, when we had excess amount we trimmed it. In a 360° peritomy for retinal detachment one patient presented a small dehiscence of the wound that was corrected with a small amount of fibrin glue.
Fibrin glue reduces surgical time, good sealent, safe, with minimal allergic or toxic reactions and inflammation, minimizes bleeding, easy to undo and that eventually disappears. This small series shows us that fibrin glue is a viable alternative for tissue cooptation in vitreoretinal surgery. However, further studies are required before fibrin glue takes the place of sutures.
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