Use of cyanoacrylate tissue adhesive in surgical repair of filtering bleb in glaucoma

( views:129, downloads:0 )
Author:
TAN Yi-lan(Department of Ophthalmology, Hunan Children's Hospital, Changsha 410007)
MAO Zhen(State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-sen University, Guangzhou 510060, China)
ZHONG Yi-min(State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-sen University, Guangzhou 510060, China)
LI Mei(State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-sen University, Guangzhou 510060, China)
XIAO Hui(State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-sen University, Guangzhou 510060, China)
CAO Dan(State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-sen University, Guangzhou 510060, China)
LIU Xing(State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-sen University, Guangzhou 510060, China)
Journal Title:
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
Issue:
Volume 16, Issue 05, 2010
DOI:
10.3760/cma.j.issn.1674-1927.2010.05.019
Key Word:
Cyanoacrylate;Tissue adhesives;Glaucoma;Filtering surgery;Treatment outcome

Abstract: Objective To evaluate the safety and efficacy of cyanoacrylate tissue adhesive in surgical repair of filtering bleb in glaucoma. Methods A study was conducted in 10 patients (10 eyes)diagnosed at the Zhongshan Ophthalmic Center, Sun Yat- sen University, between January 2007 and December 2009. Seven out of the 10 patients underwent partial resection of filtering blebs with the corneoscleral incision sealed by cyanoacrylate tissue adhesive instead of sutures, while the remaining 3 patients underwent surgical repair of filtering bleb for glaucoma in which the leakage was directly treated with cyanoacrylate tissue adhesive without suture. The vision acuity, intraocular pressure, anterior chamber depth, status of cyanoacrylate tissue adhesive, wound leakage or inflammation were observed during the follow-up for 6 to 18 months. Results In the 10 patients, the single-eye intraocular pressure was less than 6 mm Hg (1 mm Hg=0.133 kPa) and the mean intraocular pressure was (11.2±4.1 ) mm Hg before surgery,compared with over 8 mm Hg for single-eye intraocular pressure and (11.6±2.8) mm Hg for mean intraocular pressure at one month after surgery. At the end of postoperative follow-up, a mean intraocular pressure ( 11.5±3.5) mm Hg was recorded, with no significant difference as compared with the preoperative data (P>0.05).The cyanoacrylate-sealed wounds were free of leakage after surgery. On day 7 to 20 when the cyanoacrylate adhesive normally fell off, the wounds were fully healed, the filtering blebs were found scarless, and there was no inflammatory reactions in the anterior chamber. Among patients with overhanging bleb, the depth of anterior chamber was not significantly changed after surgery, except for 2 patients in whom the anterior chamber was deepened compared to the shallow one previously due to filtering bleb leakage. Conclusion Cyanoacrylate tissue adhesive may be a safe and effective alternative for sutures in partial resection and repair of filtering blebs.

  • [1]Shields MB,Scroggs MW,Sloop CM,et al.Clinical and histopathologic observations concerning hypotony after trabeculectomy with adjunctive mitomycin C.Am J Ophthalmol,1993,116:673-683.
  • [2]Myers JS,Yang CB,Herndon LW,et al.Excisional bleb revision to correct overfiltration or leakage.J Glaucoma,2000,9:169-173.
  • [3]田霞,卢永顺.二十一世纪的生物医学材料--快速医用胶(一).临床外科杂志,1999,7:48.
  • [4]黄明泉,叶婴茀.医用胶治疗眼睑裂伤.眼外伤职业眼病杂志,2003,25:850.
  • [5]Setlik DE,Seldomridge DL,Adelman RA,et al.The effectiveness of isobutyl cyanoacrylate tissue adhesive for the treatment of corneal perforations.Am J Ophthalmol,2005,140:920-921.
  • [6]Leung GY,Peponis V,Varnell ED,et al.Preliminary in vitro evaluation of 2-octyl cyanoacrylate (Dermabond) to seal corneal incisions.Cornea,2005,24:998-999.
  • [7]Ricci B,Ricci F.Octyl 2-cyanoacrylate tissue adhesive in experimental scleral buckling.Acta Ophthalmol Scand,2001,79:506-508.
  • [8]de Almeida Manzano RP,Maufal SC,Hida RY,et al.Antibacterial analysis in vitro of ethyl-cyanoacrylate against ocular pathogens.Cornea,2006,25:350-351.
  • [9]Hirst LW,Smiddy WE,Stark WJ.Corneal perforations.Changing methods of treatment,1960-1980.Ophthalmology,1982,89:630-635.
  • [10]Fogle JA,Kenyon KR,Foster CS.Tissue adhesive arrests stromal melting in the human cornea.Am J Ophthalmol,1980,89:795-802.
  • [11]Meskin SW,Ritterband DC,Shapiro DE,et al.Liquid bandage (2-octyl cyanoacrylate) ns a temporary wound barrier in clear corneal cataract surgery.Ophthalmology,2005,112:2015-2021.
  • [12]万鹏霞,何志恒,汪振芳.组织粘合剂在翼状胬肉切除联合羊膜移植术中的应用.眼科学报,2005,21:105-109.
  • [13]汤学付,董诺,汪振芳.组织粘合剂粘合羊膜手术在眼烧伤中的应用.眼科学报,2005,21:74-78.
  • [14]Rauscher FM,Barton K,Budenz DL,et al.Long-term outcomes of amniotic membrane transplantation for repair of leaking glaucoma filtering blebs.Am J Ophthalmol,2007,143:1052-1054.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn