Malafeeva A.Yu.1, Gavrilyuk I.O.1, Samusenko I.A.2, Kulikov A.N.1
1 S.M. Kirov Military medical academy, St. Petersburg
2 The Nikiforov Russian Center of Emergency and Radiation Medicine, St Petersburg
In modern ophthalmic surgery, the fixation of tissues and grafts on the ocular surface is most often carried out with the help of sutures, but in connection with the development of cell-tissue technologies, alternative seamless fixation methods are relevant. The development of this area is no less important than the search for new methods of treating diseases. A promising option for seamless fixation of tissues and grafts in ophthalmology is the use of synthetic and biological adhesive compositions. For example, the use of fibrin glue in foreign ophthalmic surgery is widely described in the literature, but its use by domestic surgeons is limited by the high cost of the finished product, as well as by little experience of use. In Russia, a medical cyanoacrylate glue «Sulfacrylate» is registered, which is used by some ophthalmic surgeons for urgent sealing of sclera and cornea wounds, as well as during operations on extraocular muscles. In 2019, the specialists of the Military medical academy of S.M. Kirov developed a method for preparing an autologous two-component fibrin glue (patent for invention RU № 2704256). It is required to conduct experimental clinical studies to introduce the developed adhesive composition into the surgical practice of ophthalmologists.
Aim: to substantiate experimentally the possibility of using an original two-component autologous fibrin glue for fixing the amniotic membrane to the corneal stroma.
Materials and methods: the study was carried out on 15 Chinchilla rabbits (30 eyes). All animals underwent superficial keratectomy without affecting the limbus. After that, a previously prepared native amniotic membrane was applied to the corneal stroma and fixed in 3 ways. The animals were divided into 3 experimental groups depending on the method of fixation of the amniotic membrane. Group A (10 eyes) — fixation with interrupted sutures, B (10 eyes) — fixation with synthetic glue «Sulfacrylate», C (10 eyes) — fixation with a developed two-component autofibrin glue. All animals underwent biomicroscopic examination of the ocular surface, photographic registration, for control periods after the operation (1st, 3rd, 5th, 7th, 10th, 14th, 21st and 30th days) as well as optical coherence tomography. The assessment of the consistency of the sutures, the degree of adherence of the amniotic membrane to the ocular surface, the transparency of the cornea. On the 30th day, histological examination of the corneas was performed.
Keywords: fibrin glue, amniotic membrane, adhesive fixation, autologous, corneal surface.
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