Bahar Irit, Kaiserman Igor, Slomovic Allan, McAllum Penny, Rootman David
Department of Ophthalmology, Toronto Western Hospital University of Toronto, Toronto, ON, Canada.
Cornea. 2007 Dec;26(10):1235-8. doi: 10.1097/ICO.0b013e318151f8e8.
To evaluate the advantages of fibrin glue for opposing wound edges in Top Hat penetrating keratoplasty (PKP).
Twenty human corneoscleral rims were mounted on an artificial anterior chamber. Eight corneas underwent traditional PKP, 6 underwent Top Hat PKP, and 6 underwent Top Hat PKP by using fibrin glue for opposing wound edges. Mechanical stability was evaluated after placement of 8 and 16 interrupted sutures. Wound bursting pressure and induced astigmatism were evaluated.
In the traditional PKP group, wound bursting pressure was 25.2 and 59.1 mm Hg after placement of 8 and 16 sutures, respectively. In the Top Hat PKP, leakage occurred at 57.6 and 103.8 mm Hg after placement of the 8 and 16 sutures, respectively. In the Top Hat PKP + fibrin glue group, wound leakage occurred at 144.6 mm Hg after placement of the 8 sutures and at >158 mm Hg after placement of 16 sutures. The Top Hat PKP + fibrin glue group induced astigmatism of 2.5 D, whereas the traditional PKP group and the Top Hat PKP group showed an induced astigmatism of 3.1 D each.
The use of fibrin glue in Top Hat PKP was found to be more mechanically stable than traditional sutures.
评估纤维蛋白胶在高帽式穿透性角膜移植术（PKP）中对合伤口边缘的优势。
将20个人类角膜缘安装在人工前房上。8只角膜接受传统PKP，6只接受高帽式PKP，6只接受使用纤维蛋白胶对合伤口边缘的高帽式PKP。在放置8根和16根间断缝线后评估机械稳定性。评估伤口破裂压力和诱导散光。
在传统PKP组中，放置8根和16根缝线后伤口破裂压力分别为25.2和59.1 mmHg。在高帽式PKP中，放置8根和16根缝线后分别在57.6和103.8 mmHg时出现渗漏。在高帽式PKP +纤维蛋白胶组中，放置8根缝线后伤口渗漏发生在144.6 mmHg，放置16根缝线后>158 mmHg。高帽式PKP +纤维蛋白胶组诱导散光为2.5 D，而传统PKP组和高帽式PKP组各显示诱导散光3.1 D。
发现在高帽式PKP中使用纤维蛋白胶比传统缝线在机械上更稳定。
