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N. Wongpitoonpiya, K. Bottos, T. Purcell, M. Isidro, D. Schanzlin; The Use of Human Fibrin Tissue Adhesive as an Alternative Method to Sutures in Deep Anterior Lamellar Keratoplasty: An Anatomical Evaluation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):735.
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© ARVO (1962-2015); The Authors (2016-present)
To demonstrate the results of using fibrin glue adhesive vs conventional sutures in Deep Anterior Lamellar Keratoplasty
Ten human eye globes and 10 donor corneas were obtained from San Diego Eye Bank. Deep anterior lamellar dissection was performed on all globes using the Anwar Big Bubble Technique. Microkeratome cut lamellar buttons were then placed on the recipient residual stromal bed. In five of the eyes, we used the traditional method of placing 16 sutures to secure the button; in the other five eyes we used fibrin glue to oppose the wound edge. We then took high resolution images of the wound edges and interface with the Anterior Segment OCT .
Evaluation by the Anterior Segment OCT demonstrated that the corneal wound edges in DALK which were applied with fibrin glue showed a smooth and regular surface comparable to the traditional 16-suture method. The fibrin glue method also resulted in reduced operation time.
Fibrin glue may be used as a modified technique to attach the corneal button in DALK without the use of sutures. This technique is fast, easy and may prevent potential complications caused by sutures. Moreover, fibrin glue use may result in less induced astigmatism. Future experiments utilizing this technique with the femtosecond laser-assisted cut may show even better results by providing more precise approximation of the wound edge.
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