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L. B. de Sousa, L. Grupenmacher, E. Lindoso; The Use of a Fibrin-Sealing Agent in Wound Closure Following Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2317.
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To investigate if it is possible to use a fibrin sealant to safely and effectively close a corneal incision following femtosecond-enabled penetrating keratoplasty.
A prospective, pilot study with 6 patients scheduled to undergo penetrating keratoplasty using a femtosecond laser (IntraLase Enabled Keratoplasty, (IEK), IntraLase FS Laser, Advanced Medical Optics, Irvine, CA) to create the donor graft, and to prepare the cornea bed in the recipient. Exclusion criteria was corneal vascularization. All patients underwent a mushroom IEK. The fibrin sealant used was a fibrinogen/thrombin combination (Beriplast, Behring). The goal of the study was to evaluate the number of sutures required when the sealant was used, as well as the inflammatory response and if the sealant was used prior to or after suture placement.
In 2 patients, the fibrin sealant was used after the placement of 4 sutures, while in the others, the sealant was used prior to placement of 8 sutures. All 6 eyes had more inflammation than seen in a typical IEK patient during the 1st postoperative week. One patient presented with a positive Seidel at week 1. All wounds were stable without any regularities.
Fibrin sealants are currently used in many areas of surgery and this small pilot study shows the potential for their use in ophthalmology, particularly in penetrating keratoplasty where the use of fewer sutures could lead to quicker visual recovery for patients.
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