比較纖維蛋白組織膠、N-butyl與methoxypropyl氰基丙烯酸酯之角膜毒性，抗菌效果以及黏合角膜切口之能力

Abstract

Purpose: To compare the corneal cytotoxicity, bacteriostatic effect, duration of adherence and the ability to seal corneal incisions among fibrin glue and two commercially available cyanoacrylate derivatives. Methods: Fibrin glue, N-butyl cyanoacrylate and methoxypropyl cyanoacrylate were compared. Corneal cytotoxicity was tested by direct contact method using bovine corneal epithelial cells, keratocytes and corneal endothelial cells challenged with droplets of adhesives. The bacteriostatic activity was verified by measuring the inhibition zones of bacterial growth surrounding adhesive droplets on agar plates inoculated with Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Mycobacterium chelonae. The duration of adherence was evaluated based on the morphological changes of adhesive drops when applied on cell culture system. The ability to seal corneal incisions was verified by the maximum resisted intraocular pressures before leakage of the rabbit corneal stab wounds sealed with tissue adhesives. Results: Methoxypropyl cyanoacrylate demonstrated the greatest corneal cytotoxocity followed by N-butyl cyanoacrylate. Fibrin glue showed no detectable cytotoxicity (p<0.01). Methoxypropyl cyanoacrylate and N-butyl cyanoacrylate showed bacteriostatic effects against Staphylococcus aureus, Streptococcus pneumoniae, and Mycobacterium chelonae but not Pseudomonas aeruginosa and Escherichia coli, while fibrin glue had no such effect against both Gram-positive and negative bacteria (p<0.01). Methoxypropyl cyanoacrylate and N-butyl cyanoacrylate demonstrated longer duration of adherence and greater ability to seal corneal incisions than fibrin glue (p<0.01). Conclusions: There is difference of corneal cytotoxicity, bacteriostatic effect, duration of adherence and the ability to seal corneal incisions among fibrin glue, N-butyl cyanoacrylate and methoxypropyl cyanoacrylate. These different properties should be considered when choosing tissue adhesives for corneal surgeries.