Journal List > J Korean Ophthalmol Soc > v.54(12) > 1009555

Park, Kim, and Woo: The Usefulness of Fibrinogen-Thrombin Adhesives for Management of Conjunctival Closure in Scleral Buckling Operation

Abstract

Purpose

We investigated the efficacy of fibrin glue for conjunctival closure in scleral buckling operations.

Methods

Thirty-seven eyes of 35 patients who underwent conjunctival closure for a scleral buckling operation with a minimum follow-up period of 3 months were evaluated. Postoperative discomfort (average score), presence of remnant adhesives, scleral buckle material infection, and wound dehiscence were evaluated prospectively in 35 eyes of 33 patients undergoing surgery with fibrin glue.

Results

The eyes showed decreasing conjunctival injection and hemorrhage over time and near to full recovered without any treatment after 1 month. With time, the average discomfort score decreased significantly (p < 0.05) and wound dehiscence was found in only 1 eye. There was no adhesive remnant in any of the eyes.

Conclusions

The use of fibrin glue for conjunctival closure in scleral buckling operations is excellent as a cosmetic and functional method. The glue can reduce postoperative discomfort and is especially useful as a method to replace conven-tional conjunctival sutures.

References

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Figure 1.
Wound dehiscence (arrow) at the nasal side after scleral buckling using tissue adhesives. But adhesion was maintained between conjunctiva and sclera. Dehiscence size decreased as time passed and nearly recovered without any treatment after 1 month.
jkos-54-1832f1.tif
Figure 2.
Series of photographs of a patient after scleral buckling using tissue adhesives. The eye showed decreasing conjunctival injection and hemorrhage as time passed and near full recovered without any treatment after 1 month.
jkos-54-1832f2.tif
Figure 3.
Discomfort sign and symptoms (average score) in the patients after scleral buckling using tissue adhesives. As time passed, the average score decreased significantly (* p < 0.05, Wilcoxon's signed-ranks test).
jkos-54-1832f3.tif
Table 1.
Baseline characteristics of patients
Characteristics  
The Number of eyes (patients) 35 (33)
Age (range, years) 41.3 ± 18.3 (16-81)
Sex (male : female) 13:20
Diagnosis (eyes)  
  Upper retinal detatchment of right eye 10
  Upper retinal detatchment of left eye 6
  Lower retinal detatchment of right eye 8
  Lower retinal detatchment of left eye 11
Types of scleral buckle  
  Radial buckle 2
  Circumferential buckle 19
  Circumferential buckle + encircling buckle 14
Buckle materials  
  Silicone tire (Mira No. 286) 3
  Silicone tire (Mira No. 287) 10
  Silicone sponge (Mira No. 506) 3
  Silicone sponge (Mira No. 515) 5
  Silicone tire (Mira No. 286) + silicone sleeve (Mira No. 270) + silicone band (Mira No. 240) 5
  Silicone tire (Mira No. 287) + silicone sleeve (Mira No. 270) + silicone band (Mira No. 240) 9
Follow-up period (weeks) 36.7 ± 21.1
Sytemic disease  
  Diabetes mellitus 2
  Hypertension 5

Values are presented as mean ± SD.

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