Preliminary Results With Butyl Cyanoacrylate/ Ethyl Cyanocetate Adhesive and Autologous Plasma Rich Growth Factors (Prgf) to Seal Corneal Lacerations

Abstract

Abstract: : PRELIMINARY RESULTS WITH BUTYL CYANOACRYLATE/ ETHYL CYANOACETATE ADHESIVE AND AUTOLOGOUS PLASMA RICH GROWTH FACTORS (PRGF) TO SEAL CORNEAL LACERATIONS Purpose: To evaluate the efficacy of a new synthetic/biologic adhesive composed of butyl cyanoacrylate/ ethyl cyanoacetate combined with PRGF to promote adhesion and corneal tissue wound healing after lamellar keratoplasty surgery. Methods:A cyanoacrylate/cyanoacetate adhesive mixture combined with P.R.G.F was used to seal the corneal flap. The flap was created by lamellar disection of the cornea with a Moria M2 Microkeratome. Synthetic adhesive was applied on the flap followed by the adherent P.R.G.F. The P.R.G.F was obtained from human blood by venipuncture and centrifuged. Cyanoacrylate monomer was synthesized by Knoevenagel reaction and alkyl cyanoacetate by Fisher esterification. We studied different adhesive formulations with an acrylic and biological base on 120 ex vivo lamb eyes. The effectivity was evaluated in order of tensile strength, hardness, speed of polimerization and corneal opacity produced by the bioadhesive. Results: We evaluated differents adhesive formulations from 5% to 50% of cyanoacrylate concentration with autologous P.R.G.F. We have found that 15 % of cyanoacrylate combined with P.R.G.F provides good corneal sealing in only 1–2 minutes. This new adhesive minimizes exotermic reaction, tissular necrosis and corneal opacification. Conclusions: A cyanoacrylate/cyanoacetate adhesive mixture combined with autologous P.R.G.F can be an alternative to sutures for corneal sealing. Ex vivo studies show good adhesive properties for corneal lamellar sealing. We need further studies to determine the physiologic role of the bioadhesive.

Keywords: cornea: clinical science • wound healing • growth factors/growth factor receptors