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M. Banitt, J. B. Malta, H. K. Soong, S. Mian; Comparison of Wound Integrity of Clear Corneal Incisions Closed With Sutures, Fibrin Adhesive, or Cyanoacrylate Adhesive. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2969. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare wound integrity of clear corneal incision when closed with sutures, fibrin adhesive (Tisseel®), or n-butyl cyanoacrylate adhesive (Histoacryl®).
Corneas of porcine eyes underwent clear corneal, two-plane incisions with a 2.75 mm keratome. The incisions were enlarged to 3.0, 4.5 and 6.0 mm with a crescent blade. Four eyes were tested for each wound closure style at each incision size. The incisions were closed with interrupted 10-0 nylon sutures (1, 2, 3 sutures at the 3.0, 4.5 and 6.0 mm incision sizes respectively), or sealed with either fibrin or cyanoacrylate tissue adhesive for each incision size. A balanced-salt infusion connected to a manometer was inserted through a limbal paracentesis. As fluid was injected into the anterior chamber, the intraocular pressure (IOP) at which there was spontaneous leakage from the wound was recorded.
Fibrin and cyanoacrylate adhesives both demonstrated higher wound leakage IOP when compared to sutures of wound leakage at the 3.0 mm incision (p<0.05). Cyanoacrylate adhesive demonstrated higher IOP of wound leakage at the 4.5 mm incision size when compared to both fibrin adhesive and sutures (p<0.05) and cyanoacrylate adhesives demonstrated higher IOP of wound leakage at the 6.0 mm incision size when compared to fibrin adhesive (p<0.05) but not sutures.
Fibrin and cyanoacrylate adhesives both provide stronger wound closure at the 3.0-mm incision size over sutures. For 4.5 mm incisions, cyanoacrylate provided stronger wound closure than both fibrin glue and sutures. At 6.0 mm incisions, cyanoacrylate provided stronger wound closure than fibrin glue but not stronger than sutures.
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