1.A comparison between the efficacy of human corneal lenticule with single blood donor fibrin glue versus sutures for sealing induced corneal penetrating wounds in porcine eyes
Jimmy Jarvis Gene C. Lo ; Raymond Nelson C. Regalado ; Ruben Lim Bon Siong
Philippine Journal of Ophthalmology 2019;44(1):9-13
Objective:
To determine the efficacy of human corneal lenticule from small incision lenticule extraction (SMILE)
with single blood donor fibrin glue as corneal patch for sealing induced corneal penetrating wounds in cadaveric
porcine eyes compared to suturing using 2 simple interrupted nylon 10-0 sutures.
Methodology:
This is an in vitro comparative experimental study using cadaveric porcine eyes. Twenty (20) porcine
eyes were randomized into control and treatment groups. A 3-mm metal keratome was used to create a fullthickness incision with the keratome angled perpendicular to the central cornea. Seidel’s test was done to confirm
leakage. An anterior chamber maintainer connected to the Centurion® Vision System (Alcon, USA) was inserted
into a peripheral corneal incision with the infusion turned off. Induced corneal penetrating wounds were sealed by
application of single blood donor fibrin glue and human corneal lenticule obtained from SMILE in the treatment
group. In the control group, 2 simple interrupted nylon 10-0 sutures were used for wound closure. Intraocular
pressure (IOP) was set at 30 mmHg using the Centurion® Vision System and IOP was increased by increments of
5 mmHg until leakage is documented.
Results:
All porcine eyes in the control group showed no leakage immediately after sealing. One out of 10 eyes
in the experimental group showed positive Seidel’s test after application of lenticule patch graft (odds ratio = 1.11
[0.904-1.336]). The mean leakage pressure for the suture group was significantly higher at 87.00 ± 4.83 mmHg
compared to the lenticule group at 30.00 + 0.00 mmHg (p-value <0.001).
Conclusion
Human corneal lenticule from SMILE with single blood donor fibrin glue as cornel patch is less
effective in sealing induced corneal penetrating wounds in cadaveric porcine eyes at IOP equal to or greater than
30 mmHg as compared to suturing using 2 simple interrupted nylon 10-0 sutures.
Fibrin Tissue Adhesive