Duffy Mark T, Bloom Jeffrey N, McNally-Heintzelman Karen M, Heintzelman Douglas L, Soller Eric C, Hoffman Grant T
Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, Illinois, USA.
J AAPOS. 2005 Aug;9(4):315-20. doi: 10.1016/j.jaapos.2005.04.007.
Bioadhesives have had limited use in ophthalmic surgery. Problems with these adhesives have included inadequate tensile strength and difficulty with their application to the tissue site. We evaluated a scaffold-enhanced cyanoacrylate bioadhesive composite as an alternative to sutures in ophthalmic surgery, including strabismus procedures.
The bioadhesive composite consisted of 2-octyl-cyanoacrylate combined with either a poly(L-lactic-co-glycolic acid) (PLGA) scaffold or a rehydrated porcine small intestine submucosa (SIS) scaffold. Extraocular rectus muscle and sclera were obtained from rabbits (n = 40) and were used, with these bioadhesive composites, to produce rectus muscle-to-sclera, sclera-to-sclera, and rectus muscle-to-rectus muscle adhesions. Control adhesions were created with cyanoacrylate only. The breaking load of the tissue repair was measured with a material strength-testing machine.
In all cases, the scaffold-enhanced cyanoacrylate adhesions were significantly stronger (P < 0.001) than the cyanoacrylate alone. The rectus muscle-to-sclera adhesions were greater than the in vivo forces reported for the horizontal rectus muscles in humans in extreme gaze.
This scaffold-enhanced bioadhesive composite produced initial muscle-sclera adhesions with strength satisfactory for strabismus surgery. It also may be applicable to other categories of ophthalmic surgery as a substitute for sutures.
生物粘合剂在眼科手术中的应用有限。这些粘合剂存在的问题包括拉伸强度不足以及难以应用于组织部位。我们评估了一种支架增强型氰基丙烯酸酯生物粘合剂复合材料，作为眼科手术（包括斜视手术）中缝线的替代品。
生物粘合剂复合材料由2-辛基氰基丙烯酸酯与聚（L-乳酸-共-乙醇酸）（PLGA）支架或复水猪小肠黏膜下层（SIS）支架组合而成。从兔子（n = 40）获取眼外直肌和巩膜，并将其与这些生物粘合剂复合材料一起用于形成直肌与巩膜、巩膜与巩膜以及直肌与直肌之间粘连。仅用氰基丙烯酸酯形成对照粘连。用材料强度试验机测量组织修复的断裂负荷。
在所有情况下，支架增强型氰基丙烯酸酯粘连显著强于单独使用氰基丙烯酸酯（P < 0.001）。直肌与巩膜之间的粘连大于人类极端注视时水平直肌所报告的体内力量。
这种支架增强型生物粘合剂复合材料产生的初始肌肉与巩膜粘连强度足以满足斜视手术要求。它也可能作为缝线的替代品应用于其他眼科手术类别。
