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Advances in the use of adhesives in ophthalmology

Chan, Stanley M; Boisjoly, Hélène

Current Opinion in Ophthalmology: August 2004 - Volume 15 - Issue 4 - p 305-310
Corneal and external disorders

Purpose of review To summarize the known uses of available medical tissue adhesives in the management of diseases of the anterior segment, highlighting recent developments in the field.

Recent findings Human fibrin glues may be used in place of cyanoacrylate tissue adhesives in the treatment of progressive corneal thinning and small perforations, potentially resulting in less corneal and conjunctival inflammatory reaction. Additional currently proposed uses of fibrin glues in ophthalmic surgery include minimizing sutures in recurrent pterygium surgery, forniceal reconstruction, amniotic membrane transplantation, and lamellar corneal grafting.

Summary After reviewing the literature pertaining to the current use of tissue adhesives in ophthalmic surgery, the authors conclude that the main indication for cyanoacrylate tissue adhesives is for the treatment of progressive corneal thinning and small, uncomplicated corneal perforations. Human fibrin glues appear to be equally effective in such cases and have the advantage of biocompatibility, allowing application over a larger surface area and the use of a superficial covering layer such as amniotic membrane or conjunctiva for further reinforcement and promotion of rapid re-epithelialization. Other applications of human fibrin glues in ophthalmic surgery are evolving, but their widespread use is limited by concern over the theoretic risk of viral transmission and the complexity of their preparation and application in comparison with traditional sutures.

Cornea Service, Hôpital Maisonneuve-Rosemont, University of Montreal, Montreal, Quebec, Canada

Correspondence to Hélène Boisjoly, Department of Ophthalmology, University of Montreal, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada

Tel: 1 514 343 7094; fax: 1 514 343 5790; e-mail: helene.boisjoly@umontreal.ca

© 2004 Lippincott Williams & Wilkins, Inc.