Sutureless Amniotic Membrane Fixation Using Fibrin Glue for Ocular Surface Reconstruction in a Rabbit Model

Szurman, Peter; Warga, M.; Grisanti, Salvatore; Roters, Sigrid; Rohrbach, Jens Martin; Aisenbrey, Sabine; Kaczmarek, Radosław; Bartz‐Schmidt, Karl Ulrich

doi:10.1097/01.ico.0000183493.00884.8f

Cited by 48 publications

(41 citation statements)

References 35 publications

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“…Treatment includes mechanical debridement and flap reattachment. Successful cases of flap attachment has been reported with no recurrence of epithelial ingrowth or fluid accumulation in the interface [107][108][109][110]. Azar et al treated recurrent epithelial ingrowth after LASIK by attaching an annular AM graft with fibrin glue [111].…”

Section: Epithelial Ingrowth and Other Laser-assisted In Situ Keratomilmentioning

confidence: 99%

Tissue adhesives in ocular surgery

Park

Champakalakshmi

Panengad

et al. 2011

Expert Review of Ophthalmology

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Section: Epithelial Ingrowth and Other Laser-assisted In Situ Keratomilmentioning

confidence: 99%

Tissue adhesives in ocular surgery

Park

Champakalakshmi

Panengad

et al. 2011

Expert Review of Ophthalmology

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“…[4][5][6][7][8] In addition, the outcomes of AMT using fibrin glue for corneal ulceration, perforation, and ocular surface reconstruction have been reported in clinical and experimental studies. [9][10][11][12][13] However, the results of pterygium surgery with AMT using fibrin tissue sealants have been evaluated in limited number of studies. Pfister and Sommers 14 were the first to report the use of fibrin glue for amniotic membrane grafting in two patients with primary and in one with recurrent pterygium.…”

Section: Introductionmentioning

confidence: 99%

Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial

Küçükerdönmez

Karalezlı

Akova

et al. 2009

Eye

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Purpose To compare the results of amniotic membrane transplantation (AMT) using fibrin glue vs vicryl sutures in pterygium surgery. Methods We carried out a prospective, randomised clinical study of 70 eyes (70 patients) with primary pterygium. After the removal of pterygium, patients were randomised to undergo AMT using fibrin glue (Tisseel, 32 eyes) or 8-0 vicryl sutures (38 eyes). Clinical examination and digital photographing were performed at each visit and the patients were followed up for at least 12 months. Post-operative symptoms in the first month were evaluated according to a fivepoint scale. Final appearances were graded from 1 to 4 in which grade 4 represented true (corneal) recurrence and grade 3 indicated conjunctival recurrence. Results The average operation time in the fibrin glue and suture groups were 11.2 ± 2.4 min (mean ± SD) and 18.7 ± 2.2 min, respectively (P ¼ 0.018). Significantly fewer post-operative symptoms were observed in the fibrin glue group at post-operative days 1, 7, and 14 (Po0.05 for all). At the end of the follow-up, true recurrence (grade 4) was developed in three eyes (9.4%) in the fibrin glue group, and in four eyes (10.5%) in the suture group (P ¼ 0.33). The rates of conjunctival recurrence (grade 3) were 21.9% (seven eyes) and 23.7% (nine eyes) in the fibrin glue and suture groups, respectively (P ¼ 0.38). Conclusions Amniotic membrane grafts can be successfully attached without any major complication in patients undergoing pterygium surgery. In addition, it is effective in shortening the duration of surgery and preventing post-operative discomfort. Although there seems to be no difference in the recurrence rates and cosmetic outcomes between both groups, neither technique represents best results.

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“…Recent findings suggest that epithelialization may occur both over and under AM when sutures are used to secure the membrane to rabbit 11 or human 12 corneas. Therefore, one may wonder whether epithelialization may be influenced by transplanted AM if sutures are used.…”

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confidence: 99%

“…26 It has been shown that in contrast to suturing, epithelial growth takes place only over AM when fibrin glue is used for central epithelial defects in rabbit corneas. 11 Therefore, we wondered whether a different healing pattern would be observed in patients' eyes with partial LSCD if AM was secured by fibrin glue to the corneal and limbal surfaces following removal of conjunctivalized epithelium. To address these questions, we retrospectively reviewed our results of AM transplantation using fibrin glue in eyes with partial LSCD.…”

mentioning

confidence: 99%

Sutureless Amniotic Membrane Transplantation for Partial Limbal Stem Cell Deficiency

Kheirkhah

Casas

Raju

et al. 2008

American Journal of Ophthalmology

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PURPOSE-To evaluate the results of sutureless amniotic membrane (AM) transplantation using fibrin glue for reconstructing corneal surfaces with partial limbal stem cell deficiency (LSCD). DESIGN-Retrospective noncomparative interventional case series.METHODS-Eleven eyes of nine patients that had LSCD with 120 degrees to almost 360 degrees of limbal involvement underwent superficial keratectomy to remove the conjunctivalized pannus followed by AM transplantation using fibrin glue. Additional sutureless AM patch (ProKera; BioTissue, Inc, Miami, Florida, USA) was used in seven patients, and mitomycin C was applied on the cornea in four eyes and during fornix reconstruction in seven eyes. The surgery was repeated in three eyes for residual pannus.RESULTS-During a mean follow-up of 14.2 ± 7.7 months (range, six to 26 months), all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect, and showed less stromal cloudiness and vascularization. Best-corrected visual acuity improved in nine eyes (81.8%). Corneal epithelialization proceeded by epithelial growth over AM (n = 4), accompanied by dissolution of AM (n = 4) or a combination of both (n = 3). No complication was noted regarding initial or repeated uses of fibrin glue.CONCLUSION-AM transplantation using fibrin glue appears to be a safe and effective method of restoring a stable corneal epithelium for cases with partial LSCD. This approach avoids the need of transplanting limbal epithelial stem cells. THE MAINTENANCE OF A HEALTHY CORNEAL EPITHElium under both normal and traumatic conditions is provided by a unique subpopulation of stem cells located at the limbus. 1,2 When limbal epithelial stem cells are destroyed and/or their supporting stromal environment becomes dysfunctional, a pathological state known as limbal stem cell deficiency (LSCD) develops (for review; see Reference 3 ). LSCD carries the cytologic evidence of conjunctivalization of the corneal surface by a goblet cell-containing conjunctival epithelium. 4 Pathologically, limbal-deficient corneas exhibit destruction of the basement membrane, superficial neovascularization, chronic inflammation, scarring, and poor epithelial integrity (for reviews; see References 3 and 5 ). Clinically, LSCD is a major cause of corneal blindness unable to be corrected by traditional corneal transplantation alone.For eyes inflicted with partial LSCD, where a part of the limbus is damaged, the corneal surface can be reconstructed by debridement of conjunctivalized epithelium with 6-8 or without 9 transplantation of amniotic membrane (AM). Several studies have shown that in eyes with partial LSCD, AM promotes expansion of remaining limbal epithelial stem cells. [6][7][8]10 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript these studies, sutures were used to secure AM to the cornea following the removal of conjunctivalized pannus from the corneal surface. Recent findings suggest that epithelialization may occur both over and unde...

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Sutureless Amniotic Membrane Fixation Using Fibrin Glue for Ocular Surface Reconstruction in a Rabbit Model

Cited by 48 publications

References 35 publications

Tissue adhesives in ocular surgery

Tissue adhesives in ocular surgery

Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial

Sutureless Amniotic Membrane Transplantation for Partial Limbal Stem Cell Deficiency

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