Abstract
Purpose: :
To evaluate the fibrin glue layer time of absorption and morphology after Sutureless Amniotic Membrane Fixation (SLAM) technique using laser scanning in vivo confocal microscopy.
Methods: :
SLAM technique is a surgical procedure using human fibrin glue as a biological glue to fix the amniotic membrane (AM) patch upon the entire corneal surface, without using suture ties and providing the simplest patch adhesion (ARVO 2007 E1882). 10 patients treated with single patch SLAM procedure were studied with a corneal confocal microscope (ConfoScan 4, Nidek Technologies). We evaluated the intensity profile, observing in the Z-scan curve the optically empty area which appears between the anterior corneal stroma and the AM basal membrane. This area represents the fibrin glue layer, and was studied by serial in vivo confocal microscopy. The follow-up confocal microscopy examination was performed at one day, at 1 week, at 15 days and at a month after surgery.
Results: :
The mean thickness of the glue layer between amniotic stroma and corneal stroma was at 1 day and at 7 days after surgery respectively 90 µm (±7 µm),and 41 µm (±5 µm). 15 days after transplant the glue was completely absorbed. After that period the AM stroma appears to be layed upon the receiver anterior corneal stroma.
Conclusions: :
In vivo confocal microscopy demonstrates that using the SLAM technique, the fibrin glue is absorbed within 15 days, allowing the perfect adesion of the amniotic membrane patch to the underlaying corneal stroma above the whole corneal surface.
Keywords: cornea: stroma and keratocytes • cornea: clinical science • transplantation