Trufanov S V
Research Institute of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2020;136(5. Vyp. 2):232-236. doi: 10.17116/oftalma2020136052232.
In modern ophthalmological practice, three types of adhesives are most often used: synthetic (cyanoacrylate), biological (fibrin), and polyethylene glycol. Cyanoacrylate adhesive is very strong and polymerizes quickly, however, is generally more toxic compared to other types of adhesives, especially if applied to highly vascularized tissues. It is also believed to have bacteriostatic activity and suppress progressive stroma lysis within the area of ulceration by inhibiting polymorphonuclear leukocytes that exhibit collagenolytic and proteolytic activity. The article presents a clinical case of effective use of Russian-made cyanoacrylate (sulfacrylate) adhesive for the treatment of corneal perforation in a patient with neurotrophic keratopathy. The use of polymer glue can be an effective, affordable, and safe alternative to other methods of urgent treatment of corneal perforations and deep ulcers, as shown by this case and literature data. Depending on the lesion location and prognosis for vision, the method can be used either independently or become a treatment stage before keratoplasty. The latter would enable delayed transplantation with lower risk of complications.
在现代眼科实践中,最常使用的粘合剂有三种类型:合成粘合剂(氰基丙烯酸酯)、生物粘合剂(纤维蛋白)和聚乙二醇。氰基丙烯酸酯粘合剂粘性很强且聚合迅速,然而,与其他类型的粘合剂相比,它通常毒性更大,尤其是应用于血管高度丰富的组织时。人们还认为它具有抑菌活性,并通过抑制表现出胶原分解和蛋白水解活性的多形核白细胞,来抑制溃疡区域内进行性的基质溶解。本文介绍了一例有效使用俄罗斯产氰基丙烯酸酯(硫代丙烯酸酯)粘合剂治疗神经营养性角膜病变患者角膜穿孔的临床病例。如本病例和文献数据所示,使用聚合物胶水可以成为角膜穿孔和深部溃疡其他紧急治疗方法的一种有效、经济且安全的替代方法。根据病变位置和视力预后情况,该方法既可以单独使用,也可以成为角膜移植术前的一个治疗阶段。后者能够实现延迟移植,降低并发症风险。