Treatment of large irregular rabbit corneal penetrating injury with fibrin glue

Abstract

Background Suture stitching is currently the standard treatment for corneal penetrating injuries.The shortcomings of suture stitching have led to the exploration of non-sutured surgical methods.Tissue adhesive is a promising non-suture replacement procedure. Objective This study was to observe the effect of fibrin glue on large irregular rabbit corneal penetrating injury. Methods Eighteen pure white healthy rabbits were randomly divided into suture group and adhesive group.A total length of 6-mm non-self-sealing corneal penetrating injury in non-pupillary-area of the right eye formed with a 15° corneal puncture knife was repaired with fibrin glue plus temporary suture and therapeutic corneal contact lens (9 eyes) or with 3 to 5 interrupted 10-0 nylon sutures (9 eyes) with the fellow eyes acted as the internal controls respectively.Operative time was compared between the two groups.Clinic observation was performed with slit lamp microscope.Animals were humanely sacrificed for histologic examination at week 1, 3, and 8 to evaluate wound healing. Results The average operation time was (3.48±0.48) minutes in the adhesive group, which was significantly lower than that in the suture group ([7.77 ± 1.30]minutes) (t=9.28, P<0.01). The postoperative slit lamp microscope observation indicated corneal wounds were quickly and regularly healed in the glued corneas compared with the stitched ones.The histologic examination revealed that glued corneas had regular healing, mild inflammation, and no corneal neovascularization, while sutured corneas showed irregular fibrin arrays, a large number of inflammatory cells and macrophages infiltration around the suture, heavy inflammatory response.Neovascularization was found at week 3 postoperatively. Conclusions Fibrin glue combined with temporary suture and therapeutic corneal contact lens is an effective treatment in sealing large irregular corneal wounds with considerable advantages over traditional sutures, including simplified operative technique, short surgery time, less postoperative irritation, mild inflammation, more regular wound healing, short healing time, and no corneal neovascularization. Key words: Fibrin glue; Suture; Full-thickness corneal penetrating injury; Disease model/animal; Corneal contact lens/therapeutic