Oberg Thomas J, Friday Jason W, Ursea Roxanna, Snyder Robert W
University of Arizona, USA.
Cornea. 2009 Jul;28(6):681-7. doi: 10.1097/ICO.0b013e3181a2aa5c.
It is well known that Tisseel Fibrin Sealant provides an excellent tissue adhesive. However, its thick and viscuous nature makes it nearly impossible to apply it in a uniform and thin layer. We propose applying the sealant phase as a dry powder and polymerizing it in-vivo by exposing it to thrombin solution after a graft has been placed.
For each experiment two rabbit corneal buttons were affixed to each other using either Tisseel or thrombin plus dry fibrinogen component, the tensile strength of the bond was then tested in the tension box. Balanced salt solution was used as an aqueous substitute.
Tisseel was demonstrated to create significant adhesive tensile force (expressed as N/m) between corneal buttons (P < 10). Using only the dry fibrinogen component followed by injection of the thrombin solution directly into the balanced salt solution did not significantly alter the strength of the bond (P = 0.18).
The use of the dry fibrinogen component followed by injection of thrombin solution into the balanced salt solution, without the accompanying fibrinolysis inhibitor, is equally effective in adhesive strength when compared to complete Tisseel. This technique may be used in lamellar corneal surgery, although there would be potential difficulties with its application in the in vivo setting.
众所周知，Tisseel纤维蛋白封闭剂是一种出色的组织粘合剂。然而，其浓稠的性质使其几乎不可能均匀地薄层涂抹。我们建议将封闭剂阶段制成干粉，并在植入移植物后将其暴露于凝血酶溶液中使其在体内聚合。
在每个实验中，使用Tisseel或凝血酶加干纤维蛋白原成分将两个兔角膜纽扣彼此固定，然后在张力箱中测试结合的拉伸强度。使用平衡盐溶液作为水性替代物。
结果表明，Tisseel在角膜纽扣之间产生了显著的粘合拉力（以N/m表示）（P < 10）。仅使用干纤维蛋白原成分，然后将凝血酶溶液直接注入平衡盐溶液中，并未显著改变结合强度（P = 0.18）。
与完整的Tisseel相比，使用干纤维蛋白原成分，然后将凝血酶溶液注入平衡盐溶液中，且不使用伴随的纤维蛋白溶解抑制剂，在粘合强度方面同样有效。尽管该技术在体内应用可能存在潜在困难，但可用于板层角膜手术。
