Wound integrity of clear corneal incisions closed with fibrin and N-butyl-2-cyanoacrylate adhesives.
OBJECTIVE
To compare the integrity of clear corneal incisions closed with fibrin (Tisseel) and n-butyl-2-cyanoacrylate (Histoacryl) tissue adhesives to those closed with conventional sutures.


METHODS
Four replicate experiments were performed on porcine eyes with each of the following conditions: three limbal clear corneal incision sizes (3.0 mm, 4.5 mm, and 6.0 mm), three incision closure techniques (fibrin adhesive, n-butyl-2-cyanoacrylate adhesive, and 10-0 interrupted nylon sutures)-1, 2, and 3 sutures at the 3.0-mm, 4.5-mm, and 6.0-mm incision sizes, respectively. Wound integrity was then measured by elevating the intraocular pressure of the eye to the point where wound leakage (IOP(L)) occurred. Two-way repeated measures analysis of variance (ANOVA) was used to analyze the IOP(L) data.


RESULTS
Incision closure technique and incision size showed significant interaction in the ANOVA model (p = 0.0008). Fibrin adhesive demonstrated higher IOP(L) compared to suture closure at the 3.0-mm incision size (p < 0.0001). There was no significant difference in IOP(L) when comparing wound closure with fibrin adhesive and sutures at the 4.5-mm and 6.0-mm incision sizes (p = 0.52 and p = 0.56, respectively). There was no significant difference between the three closure techniques for the 6.0-mm incisions (p > 0.15). When comparing the wound closure techniques for all incision sizes, the mean IOP(L) significantly increased in the following order: suture(s), fibrin adhesive, n-butyl-2-cyanoacrylate glue.


CONCLUSIONS
Fibrin or n-butyl-2-cyanoacrylate tissue adhesive may be used as a more stable alternative to conventional sutures in the closure of clear corneal incisions.
Banitt
Michael
M
Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Malta
João Baptista
JB
Soong
H Kaz
HK
Musch
David C
DC
Mian
Shahzad I
SI
D000818:Animals; D003315:Cornea / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty; D004659:Enbucrilate / Q000008:administration & dosage*; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D007429:Intraocular Pressure; D009798:Ocular Hypertension; D013529:Surgical Wound Dehiscence / Q000503:physiopathology / Q000517:prevention & control*; D013536:Suture Techniques; D013552:Swine; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D004659:Enbucrilate