Comparison of the bacteriostatic effects, corneal cytotoxicity, and the ability to seal corneal incisions among three different tissue adhesives.
OBJECTIVE
To compare the bacteriostatic effects, corneal cytotoxicity, and ability to seal corneal incisions among fibrin glue and 2 commercially available cyanoacrylate derivatives: N-butyl cyanoacrylate and methoxypropyl cyanoacrylate.


METHODS
The bacteriostatic activities of these tissue glues were verified by measuring the zones of bacterial growth inhibition surrounding the adhesive droplets on agar plates inoculated with Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Escherichia coli, or Mycobacterium chelonae. Corneal cytotoxicity was tested by a direct contact method by using cultured bovine corneal epithelial cells, keratocytes, and corneal endothelial cells challenged with droplets of adhesives. Each of the cells was treated with droplets of adhesives. The ability to seal corneal incisions was verified by calculating the maximum intraocular pressure resistant to leakage of rabbit corneal stab wounds sealed with tissue adhesives.


RESULTS
Methoxypropyl cyanoacrylate and N-butyl cyanoacrylate showed bacteriostatic effects against S. aureus, S. pneumoniae, and M. chelonae but not P. aeruginosa and E. coli. In contrast, fibrin glue had no such effects against either Gram-positive or -negative bacteria (P < 0.01). Methoxypropyl cyanoacrylate showed the highest levels of corneal cytotoxicity, followed by N-butyl cyanoacrylate. Fibrin glue, however, showed minimal cytotoxicity (P < 0.01). Methoxypropyl cyanoacrylate and N-butyl cyanoacrylate also displayed a greater ability to seal corneal incisions than that of fibrin glue (P < 0.01).


CONCLUSIONS
The bacteriostatic effects, corneal cytotoxicity, and ability to seal corneal incisions differed among the 3 compounds tested. These different properties should be considered when choosing tissue adhesives during corneal surgery.
Chen
Wei-Li
WL
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Lin
Chung-Tien
CT
Hsieh
Chia-Yun
CY
Tu
I-Hua
IH
Chen
Willie Y W
WY
Hu
Fung-Rong
FR
D000818:Animals; D001419:Bacteria / Q000187:drug effects*; D002417:Cattle; D002478:Cells, Cultured; D065306:Corneal Injuries; D003487:Cyanoacrylates / Q000494:pharmacology / Q000633:toxicity; D004195:Disease Models, Animal; D004659:Enbucrilate / Q000031:analogs & derivatives / Q000494:pharmacology / Q000633:toxicity; D004728:Endothelium, Corneal / Q000187:drug effects*; D019573:Epithelium, Corneal / Q000187:drug effects*; D015807:Eye Injuries, Penetrating / Q000188:drug therapy* / Q000503:physiopathology; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology / Q000633:toxicity; D007429:Intraocular Pressure; D008826:Microbial Sensitivity Tests; D011817:Rabbits; D013529:Surgical Wound Dehiscence / Q000503:physiopathology; D014014:Tissue Adhesives / Q000494:pharmacology* / Q000633:toxicity*; D014945:Wound Healing / Q000187:drug effects
D003487:Cyanoacrylates; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D004659:Enbucrilate