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Fibrin glue aids adherence in lamellar keratoplasty
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LISBON, Portugal — Fibrin glue can be used to create a uniform adherence of host Descemet’s membrane to donor stroma during total anterior lamellar keratoplasty, said Thomas John, MD.
Dr. John presented results here at the European Society of Cataract and Refractive Surgeons meeting on 10 patients who underwent total anterior lamellar keratoplasty (TALK) with fibrin glue used for adherence.
He defined the TALK procedure as “complete exposure of Descemet’s membrane within the area of host corneal trephination combined with transplantation of donor cornea that is devoid of membrane and endothelium.”
Patients in his series ranged in age from 33 to 67 years, with a mean age of 48 years. Indications for the procedure were keratoconus in seven patients and corneal scarring in three. The average follow-up was 6 months.
Surgeons “cannot use an automated technique in TALK,” he said, so manual corneal lamellar dissection was used in all cases. During TALK, Descemet’s is “fully exposed up to the trephination mark,” he said.
The fibrin glue has two components, thrombin and fibrinogen, Dr. John said.
“It’s bioabsorbable and biocompatible,” he added.
Because it helps create tissue adhesion in a wet environment, the fibrin glue can result in an even, smooth adherence of host Descemet’s membrane to donor stroma.
“No Descemet’s membrane folds or interface pocket was seen in any of the eyes,” he said. “Postoperative healing was uniform, without any inflammation or interface scarring of the cornea.”
Lastly, he said, the glue dissolves and disappears within 24 hours after TALK surgery.