Comparison of Sutures and Dendritic Polymer Adhesives for Corneal Laceration Repair in an In Vivo Chicken Model
Comparison of Sutures and Dendritic Polymer Adhesives for Corneal Laceration Repair in an In Vivo Chicken Model
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DOI：
10.1001/archophthalmol.2008.582
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发表时间：
2009-04-01
影响因子：
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通讯作者：
Kim, Terry
中科院分区：
文献类型：
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作者：
Berdahl, John P.;Johnson, C. Stark;Kim, Terry
目的：比较缝线和新型高分子胶粘剂修复角膜撕裂伤的临床和组织学愈合情况。方法：对60只白来角鸡右眼行中心全层4.1 mm撕裂伤。一半伤口用生物树突聚合物胶粘剂治疗，另一半伤口用3条10-0尼龙缝合线缝合。裂隙灯检查每6小时进行一次，每天7天，每周21天。分别于第1、3、7、28天处死动物，进行组织学检查，评估角膜愈合情况。结果：第1、3、7天的组织学观察显示粘接创面充满纤维蛋白，然后是增生性上皮，随后是瘢痕组织。胶合角膜在第7天瘢痕形成更为明显；然而，在第28天，缝合的角膜表现出更多的炎症和疤痕，并且角膜前表面更加不规则。临床上，所有胶合的角膜都保持清晰，而几乎所有缝合的角膜都有一定程度的角膜瘢痕持续到28天。使用密封剂的手术比使用缝线的手术快5倍。结论：胶粘剂治疗角膜撕裂伤较缝合线愈合好。临床意义：生物树突粘接剂是一种安全、有效、技术上更容易替代传统缝线修复角膜穿孔的方法。
Objective: To compare clinical and histologic healing of corneal lacerations repaired by sutures or a new polymeric adhesive.Methods: A central full-thickness 4.1-mm laceration was made in the right eyes of 60 white leghorn chickens. Half of the wounds were treated with biodendrimer polymer adhesive and half were closed with 3 interrupted 10-0 nylon sutures. Slitlamp examination was performed at 6 hours, daily for 7 days, and weekly for 21 days. Animals were humanely killed at days 1, 3, 7, and 28 for histologic examination to evaluate corneal healing.Results: Histologic observations on days 1, 3, and 7 showed glued wounds filled with fibrin, then hyperplastic epithelium, and subsequently scar tissue. Scarring was more prominent at day 7 in glued corneas; however, by day 28, sutured corneas exhibited more inflammation and scarring and much more irregular anterior corneal surfaces. Clinically, all glued corneas remained clear while nearly all sutured corneas had some degree of corneal scarring persisting through day 28. The procedure was about 5 times faster with sealant than with sutures.Conclusion: Corneal lacerations treated with adhesive heal favorably compared with sutures.Clinical Relevance: Biodendrimer adhesives represent a safe, effective, and technically easier alternative to traditional suture repair of corneal perforations.