Experimental epikeratophakia with biological adhesive.

Area of Science:

• Ophthalmology
• Biomaterials Science
• Surgical Innovation

Background:

• Corneal transplantation, including epikeratophakia, traditionally relies on sutures for graft fixation.
• Suturing can prolong operative time and potentially lead to complications.
• Developing sutureless techniques is crucial for improving surgical efficiency and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of a biological adhesive as a sutureless method for epikeratophakia grafting.
• To compare the graft retention rates and operative time of adhesive-assisted versus suture-based epikeratophakia.
• To assess the feasibility of using Tisseel in conjunction with an antifibrinolytic agent for corneal grafting.

Main Methods:

• Experimental epikeratophakia grafting was performed in a rabbit model.
• A two-component biological adhesive system (Tisseel) based on fibrinogen and thrombin was utilized.
• The adhesive was applied with an antifibrinolytic agent, and operative techniques were modified.
• Graft retention was compared between the adhesive group and a control group using conventional suturing.

Main Results:

• The use of a biological adhesive eliminated the need for corneal suturing.
• Operative time was reduced to one-third compared to sutured procedures.
• Epikeratophakia grafts secured with adhesive showed a 70% retention rate.
• Grafts without adhesive achieved a 50% success rate in the rabbit model.

Conclusions:

• Biological adhesives provide a viable sutureless alternative for epikeratophakia grafting.
• This technique significantly reduces surgical duration and enhances graft survival.
• Further research may explore the broader application of adhesive-based methods in ophthalmic surgery.