title: Rapid preparation of small-volume autologous fibrinogen concentrate and its same day use in bleb leaks after glaucoma filtration surgery.
abstract: The authors evaluated small-volume preparation of autologous fibrin glue (AFG) and same day use in postglaucoma filtration surgery patients with Seidel positive bleb leaks and determined fibrinogen concentrations in autologous fibrinogen concentrates (AFCs) from 10 volunteers. Thirty milliliters of blood was centrifuged (5 min, 2400 x g); plasma was frozen (5 min-ethanol and ice), thawed (1-6 C, 30-60 min), and centrifuged (10 min, 5 C, 2800 x g); and the precipitate was transferred to a 1.0-ml tuberculosis syringe. Thrombin (1000 U) was dissolved (0.8 sterile water, 0.2 ml aminocaproic acid) and warmed (37 C). Average preparation time was 90 minutes. Alternating drops of AFC and thrombin were applied to bleb leaks until AFC clotted. Seidel testing with fluorescein determined success. AFC was prepared from 10 volunteers and fibrinogen was measured. AFG was initially successful with two (Seidel negative) eyes; one eye remained negative. AFG was unsuccessful in one briskly Seidel-positive leak. Mean +/- SD fibrinogen concentration in AFCs from the 10 volunteers was 2314 +/- 643 mg/dl (range 1608-3431 mg/dl). AFG may successfully close bleb leaks in outpatient settings. Brisk aqueous flow may impair effectiveness of AFG. Fibrinogen concentrations were comparable with previous reports.
authors.affiliation: Blood Bank and Transfusion Services, University of Virginia, Charlottesville 22908, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Gammon
authors.forename: B E
authors.initials: BE
authors.lastname: Prum
authors.forename: N
authors.initials: N
authors.lastname: Avery
authors.forename: P D
authors.initials: PD
authors.lastname: Mintz
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000302:isolation & purification* / Q000627:therapeutic use; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000188:drug therapy*; D013048:Specimen Handling / Q000379:methods; D014014:Tissue Adhesives / Q000302:isolation & purification* / Q000627:therapeutic use; D014130:Trabeculectomy / Q000009:adverse effects*
chemical_list: D015718:Fibrin Tissue Adhesive; D009883:Ophthalmic Solutions; D014014:Tissue Adhesives; D016685:Mitomycin