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J.P. Fang, K.H. Baratz; Comparison between fibrin glue and sutures to attach preserved human amniotic membranes to rabbit corneas . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3943.
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Purpose: To compare the use of fibrin glue with sutures as methods of attaching human amniotic membranes grafts (AMG) to the cornea. Methods: New Zealand albino rabbits weighing between 2–3 kg were anesthetized and a standardized central corneal epithelial defect (6 mm) was made in both eyes of each rabbit. In the first phase of the experiment, one eye received a 5 mm preserved, human, AMG secured by a running 10–0 nylon suture while the contralateral eye received a similar AMG secured by Tisseel fibrin glue alone. After surgery, topical ocuflox drops were applied twice daily until the epithelium healed. The size of the epithelial defect was measured using calipers and digital photographs were taken daily. In the second phase of the experiment, a 6mm lamellar keratectomy of approximately 50% stromal depth was made in both corneas of each rabbit. The remaining steps for attaching the AMG to the corneal defect were the same as those for the first phase of the study except 6 mm membranes were used. Results: In phase one of the study, all membranes attached using fibrin glue sloughed off by the first post–operative day (4/4). In the eyes with AMG attached using sutures, three of four membranes remained attached at post–operative day seven before sloughing off by post–operative day fourteen. None of the membranes epithelialized prior to sloughing. In the second phase of the study, half of the AMGs attached using fibrin glue initially remained at the first post–operative day (1/2) but subsequently sloughed off by the second post–operative day. With sutures, all of the membranes remained attached to the cornea (2/2). Conclusions: Although fibrin glue cannot maintain an AMG on the corneal surface following an epithelial defect, traditional sutures are also not sufficient in our animal model. With a lamellar defect, however, sutures appear superior to fibrin glue.
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