Fibrin Glue as a Suture Substitute - Histological Evaluation of Scleral Flap and Conjunctival Wound Healing in Rabbit Eyes

Abstract

Abstract: : Purpose: The purpose of this study was to evaluate the effect of fibrin glue (Quixil) on histological processes on scleral flaps and conjunctival wound closure in rabbit eyes. Methods: Twenty eyes of New-Zealand albino adult rabbits were operated. Conjunctival peritomy and scleral flap were performed and fibrin glue was used to attach the tissue ( instead of sutures ). The rabbits’ eyes were divided into two groups : 14 eyes in a fibrin glue and 6 eyes in a control group. The rabbits’ eyes were examined under a light microscope at 2,3,7,9,14,21,30 days after surgery . Histopathologic examinations assessed the presence of glue in the tissue, degree of capillary congestion, inflammatory reaction, and collagen density ( scar formation ). Results: The glue could be well identified in the tissue as an amorphic eosinophilic substance for up to three days, and had nearly disappeared by day 7. Acute inflammatory reaction was noted for up to 14 days and converted to chronic inflammation by day 30. Collagen and scar formation were also present by day 30. The adhesive had no adverse effects on ocular tissue and did not lead to any signs of intraocular inflammation: it induced mild to moderate local inflammatory reaction, quite similar to that seen in the control group. Conclusions: Quixil was found to be well tolerated by ocular tissue and did not lead to intraocular inflammation or interfered with usual scar formation. We suggest that fibrin adhesive might be an effective method as a suture substitute for conjunctival and scleral wound closure in glaucoma surgery.

Keywords: wound healing • conjunctiva • sclera