Fibrin glue for closing conjunctival wounds in ophthalmic surgery

Abstract

Abstract: : Purpose: Tissue adhesives offer the attractive prospect of sutureless surgery and provide a mechanism for repairing potentially difficult surgical wounds. We examined the ability fibrin glue –instead of sutures– to close conjunctival wounds at the end of different ophthalmic surgeries. Methods: Between 2002 and 2003 the fibrin glue Beriplast® was used in our department to close the conjunctival wound in 100 eye muscle surgeries, 10 scleral buckling procedures in retinal detachment and in 20 pars plana vitrectomies. Results: No patient showed postop. adverse or allergic reactions, bacterial infections, inflammation or delayed healing. The healing process of the conjunctiva takes a similar time course as in suture closure, but without disturbing suture ends and knots. In children with much tenonâ|*128*|^TMs fascia the adaptation of the conjunctiva is safer using sutures. The necessary time using fibrin glue is reduced to one fourth of the usual 4 to 8 minutes necessary for suturing the conjunctiva. The costs for fibrin glue are the same as for Vicryl 9/0®, i.e., approximately 18 to 20 Euros per patient. Conclusions: Fibrin glue for closing conjunctival wounds results in a good adaptation, is time saving, effective and not more expensive than a suture with a high end needle. Especially the thin atrophic conjunctiva in adults will tear using sutures in contrast to the very fast and effective adaptation with fibrin glue. A restriction for the application of fibrin glue are children with much tenonâ|*128*|^TMs fascia: in these patients a suture is superior for good adaptation of the conjunctiva.

Keywords: strabismus: treatment • conjunctiva • wound healing