Fibrin Glue for Closing Conjunctival Wounds in Ophthalmic Surgery
Centre for Ophthalmology, Justus-Liebig University Giessen, Dept. of Strabology and Neuro-ophthalmology
Purpose: The use of fibrin glue in ophthalmic surgery started already 25 years ago, but the range of indications decreased in the last 10 years. One reason is the turn of the most frequent surgical procedure, i.e., cataract surgery into a clear cornea procedure. On the other hand, the existing very high safety of blood plasma products opens the way for fibrin glue as a very interesting alternative for suture closure of the conjunctiva.
Method: Between 2002 until 2003 we applied the fibrin glue Beriplast® (Aventis Behring© , 65832 Liederbach, Germany) for conjunctival closure instead of suture adaptation in 100 eye muscle surgeries, 10 scleral buckling procedures in retinal detachment and in 20 pars plana vitrectomies. 10 % of all cases had prior surgery with conjunctival opening. The fibrin glue consists of fibrinogen and aprotinin as well as thrombin and CaCl. Both components were prepared (each 0.1 ml) in insulin syringes prior to all surgeries of the day. The postop. course consists of objective (looking for adaptation of conjunctiva, degree of chemosis and hyposphagma, superficial keratitis or corneal dellen) and subjective (foreign body sensation, tearing of the eye) evaluation and comparing this to suture adaptation.
Results: Fibrin glued conjunctiva shows excellent adaptation to a price not higher than suture fixation and is less time consuming than suturing. This a
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