The Usefulness of Fibrinogen-Thrombin Adhesives for Management of Conjunctival Closure in Scleral Buckling Operation

PURPOSE: We investigated the efficacy of fibrin glue for conjunctival closure in scleral buckling operations. METHODS: Thirty-seven eyes of 35 patients who underwent conjunctival closure for a scleral buckling operation with a minimum follow-up period of 3 months were evaluated. Postoperative discomfort (average score), presence of remnant adhesives, scleral buckle material infection, and wound dehiscence were evaluated prospectively in 35 eyes of 33 patients undergoing surgery with fibrin glue. RESULTS: The eyes showed decreasing conjunctival injection and hemorrhage over time and near to full recovered without any treatment after 1 month. With time, the average discomfort score decreased significantly (p < 0.05) and wound dehiscence was found in only 1 eye. There was no adhesive remnant in any of the eyes. CONCLUSIONS: The use of fibrin glue for conjunctival closure in scleral buckling operations is excellent as a cosmetic and functional method. The glue can reduce postoperative discomfort and is especially useful as a method to replace conventional conjunctival sutures.

Fibrin Glue for Conjunctival Closure in Pars Plana Vitrectomy

PURPOSE: To investigate the efficacy of fibrin glue for conjunctival closure in vitrectomy. METHODS: Two hundred five eyes of 200 patients who underwent conjunctival closure for vitrectomy with a minimum follow-up period of six months were evlauated. Postopertive pain, foreign body sensation, tearing, subconjunctival hemorrhage, surgery time and complication were evaluated prospectively in 105 eyes of 100 patients undergoing surgery with fibrin glue, and in 100 eyes of 100 patients undergoing surgery with sutures. RESULTS: One day postoperatively, pain scores (p< 0.05), foreign body sensation (p< 0.05), tearing (p< 0.05), and subconjunctival hemorrhage (p< 0.05) were significantly lower in the fibrin glue group than in the suture group. One week postoperatively, the scores of foreign body sensation (p< 0.05), tearing (p< 0.05), subconjunctival hemorrhage (p< 0.05) were significantly lower in the fibrin glue group than in the suture group. The mean surgery time in the fibrin glue group (2.2+/-0.5 minutes) was significantly shorter than that in the sutures group (7.4+/-0.6 minutes) (p< 0.05). CONCLUSIONS: The Use of fibrin glue for conjunctival closure in vitrectomy can reduce postoperative discomfort and surgical time. It is especially useful for a second operation or for cases with a thin, atrophic conjunctiva.