Leahey A B, Gottsch J D, Stark W J
Wilmer Ophthalmologic Institute, Johns Hopkins Hospital, Baltimore, MD 21287-9135.
Ophthalmology. 1993 Feb;100(2):173-80. doi: 10.1016/s0161-6420(93)31674-x.
To investigate the indications, outcomes, and complications of N-butyl cyanoacrylate tissue adhesive for ocular clinical use. This tissue adhesive is under investigation by the Food and Drug Administration.
N-butyl cyanoacrylate was used as an investigational device on 44 patients at the authors' institution over a 2-year period. The charts of these patients were reviewed.
The indications for glue application included corneal perforation (19 eyes), descemetoceles (9 eyes), leaking filtering blebs (6 eyes), stromal thinning (5 eyes), wound leaks (4 eyes), and exposure keratopathy (1 eye). A bandage contact lens was used over the dried tissue adhesive in 38 of the 44 eyes. Length of glue adherence ranged from 1 to 660 days (mean, 72 days). Outcome was penetrating keratoplasty (19 eyes), no further intervention (14 eyes), enucleation (4 eyes), surgical revision of a filter (2 eyes), scleral patch graft (1 eye), conjunctival transplant (1 eye), failed tarsorrhaphy (1 eye), suturing of wound (1 eye), and a lamellar graft (1 eye). Vision improved in 52% (23/44) of eyes.
This tissue adhesive may soon be available to all ophthalmologists, and the authors' experience demonstrates that it is an effective method of temporary or permanent closure of an impending or frank perforation.
研究氰基丙烯酸正丁酯组织黏合剂在眼科临床应用的适应证、疗效及并发症。该组织黏合剂正在接受美国食品药品监督管理局的调查。
在两年时间里，作者所在机构将氰基丙烯酸正丁酯作为试验器械应用于44例患者。对这些患者的病历进行了回顾。
应用黏合剂的适应证包括角膜穿孔（19眼）、后弹力层膨出（9眼）、滤过泡渗漏（6眼）、基质变薄（5眼）、伤口渗漏（4眼）及暴露性角膜病变（1眼）。44眼中的38眼在干燥的组织黏合剂上使用了绷带式隐形眼镜。黏合剂附着时间为1至660天（平均72天）。治疗结果为穿透性角膜移植术（19眼）、无需进一步干预（14眼）、眼球摘除（4眼）、滤过手术修正（2眼）、巩膜补片移植（1眼）、结膜移植（1眼）、睑裂缝合术失败（1眼）、伤口缝合（1眼）及板层移植（1眼）。52%（23/44）的患眼视力得到改善。
这种组织黏合剂可能很快可供所有眼科医生使用，作者的经验表明它是一种临时或永久性封闭即将发生或已发生的穿孔的有效方法。
