Vera L, Benzerroug M, Gueudry J, Varin R, Haghighat S, Gérard G, Muraine M
Service d'ophtalmologie, Hôpital Charles Nicolle, Boulevard Gambetta, Rouen, France.
J Fr Ophtalmol. 2009 Apr;32(4):290-305. doi: 10.1016/j.jfo.2009.01.008. Epub 2009 Mar 19.
Tissue adhesives have a long history of use in almost all surgical disciplines, both as an alternative and a complement to sutures. Nevertheless, ophthalmologists have restricted knowledge of their potential applications; consequently, tissue adhesives have been underutilized so far. This review discusses the most relevant clinical and experimental advances in the use of tissue adhesives in ophthalmology and details the characteristics and properties of the glues. Among the currently available adhesives, synthetic glues are mainly represented by cyanoacrylates and biologic glues by fibrin-based adhesives. Cyanoacrylate-based glues are especially useful for treating perforated or preperforated corneal ulcers and performing temporary tarsorrhaphy. Fibrin-based glues have the largest field of application, as they can be used in corneal perforations and are being widely used in pterygium surgery and conjunctival surgery. We also reviewed other anecdotic applications of these adhesives. Novel biomaterials such as biodendrimers, polyethylene glycols, modified chondroitin sulfates, and acrylic copolymers show promising results in the experimental field, and one product has been on the market for a short period of time.
组织粘合剂在几乎所有外科领域都有悠久的使用历史,既作为缝线的替代品,也作为缝线的补充。然而,眼科医生对其潜在应用的了解有限;因此,到目前为止,组织粘合剂的使用未得到充分利用。本综述讨论了眼科使用组织粘合剂方面最相关的临床和实验进展,并详细介绍了胶水的特性和性能。在目前可用的粘合剂中,合成胶水主要以氰基丙烯酸酯为代表,生物胶水以纤维蛋白基粘合剂为代表。氰基丙烯酸酯基胶水特别适用于治疗穿孔性或即将穿孔的角膜溃疡以及进行临时性睑裂缝合术。纤维蛋白基胶水的应用领域最广,因为它们可用于角膜穿孔,并且正在广泛应用于翼状胬肉手术和结膜手术。我们还回顾了这些粘合剂的其他一些轶事性应用。新型生物材料,如生物树枝状大分子、聚乙二醇、改性硫酸软骨素和丙烯酸共聚物,在实验领域显示出有前景的结果,并且有一种产品已在市场上销售了很短一段时间。