title: Sutureless fixation of amniotic membrane patch as a therapeutic contact lens by using a polymethyl methacrylate ring and fibrin sealant in a rabbit model.
abstract: OBJECTIVE
  To introduce and evaluate a sutureless technique by using a polymethyl methacrylate (PMMA) ring and fibrin sealant to fix an amniotic membrane (AM) patch on the ocular surface as a therapeutic contact lens in a rabbit model.
  
  
  METHODS
  PMMA rings were fabricated by duplicating an impression of a rabbit conjunctival fornix. The central cornea of the left eye in 16 rabbits was deepithelialized (diameter = 10 mm). A human AM patch was fixed to the ocular surface by using either a PMMA ring and fibrin sealant or interrupted 10-0 nylon sutures. The fibrin sealant was used to create the PMMA ring-AM complex but not to attach the AM/PMMA ring to the ocular surface. The rabbits were followed up with slit-lamp examination and fluorescein staining for 7 days. Reepithelialization and complications were recorded.
  
  
  RESULTS
  The corneal epithelial defect was recovered in each rabbit of both groups after 5 days. In the sutureless group, all membranes remained in place and intact during the follow-up period. One eye was noted to have a partial conjunctival epithelial defect caused by exposure to the PMMA ring. In contrast, >50% of rabbits in the interrupted suture group exhibited complications including conjunctival edema, suture loosening, patch detachment, bleeding, and conjunctival epithelial defects.
  
  
  CONCLUSIONS
  The sutureless technique that uses a PMMA ring and fibrin sealant for AM patch placement has a lower incidence of complications than the interrupted suture method. This sutureless technique may promote increased clinical use of AM patch by alleviating patients' pain and shortening surgical time.
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Bing-Qian
authors.initials: BQ
authors.lastname: Liu
authors.forename: Zhi-Chong
authors.initials: ZC
authors.lastname: Wang
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Liu
authors.forename: Jing-Bo
authors.initials: JB
authors.lastname: Liu
authors.forename: Nai-Yang
authors.initials: NY
authors.lastname: Li
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Wang
authors.forename: Ping
authors.initials: P
authors.lastname: Ma
authors.forename: Ru-Zhang
authors.initials: RZ
authors.lastname: Jiang
authors.forename: Jian
authors.initials: J
authors.lastname: Ge
mesh_terms: D000650:Amnion / Q000637:transplantation*; D000818:Animals; D003261:Contact Lenses; D019573:Epithelium, Corneal / Q000502:physiology; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D023421:Models, Animal; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D011817:Rabbits; D012038:Regeneration; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014945:Wound Healing
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D019904:Polymethyl Methacrylate