The Application of Fibrin Glue (Tissucol Duo Quick) in External Eye Surgeries
Condition: Corneal Ulcers; Cataract; Pterygium; Retinal Detachment
MeSH terms: Corneal Ulcer; Cataract; Retinal Detachment; Pterygium
Study type: Interventional

Summary: 
      The fibrin sealants are prepared from fibrinogen, thrombin, and sometimes factor XIII that
      have been purified from human plasma. Tissucol Duo Quick (Baxter, Vienna, Austria) is a kind
      of fibrin sealants with popular use. It is a 2-component tissue adhesive that resembles
      natural fibrin formation. This glue has 2 components: fibrinogen (mixed with factor XIII and
      aprotinin) and thrombin-CaCl2 solution. When equal amounts of the 2 components are mixed, the
      monomers aggregate by cross-linking, resulting in a fibrin clot. It forms a elastic, whitish
      substance and provides strong adhesion to the tissue. Therefore, it is a good agent to seal
      small wounds or to replace the use of suture.
    

Detailed description: 
      Biologic adhesives have been used in medicine for many years. It has been applied to numerous
      surgical fields. As for the ophthalmic field, The use of organic glues has provided good
      results for the repair of leaking blebs and perforated corneal ulcers, conjunctival closure
      in strabismus surgery, surgery for retinal detachment, cataract surgery, trabeculectomy, and
      mucous membrane grafting to repair lesions of the conjunctival fornix. The fibrin sealants
      are prepared from fibrinogen, thrombin, and sometimes factor XIII that have been purified
      from human plasma. Tissucol Duo Quick (Baxter, Vienna, Austria)is a kind of fibrin sealants
      with popular use. It is a 2-component tissue adhesive that resembles natural fibrin
      formation. This glue has 2 components: fibrinogen (mixed with factor XIII and aprotinin) and
      thrombin-Calcium Chloride solution. When equal amounts of the 2 components are mixed, the
      monomers aggregate by cross-linking, resulting in a fibrin clot. It forms a elastic, whitish
      substance and provides strong adhesion to the tissue. Therefore, it is a good agent to seal
      small wounds or to replace the use of suture.

      Pterygium is a triangular-shaped growth of abnormal conjunctival tissue that extends
      horizontally from the bulbar conjunctiva, across the limbus, and onto the cornea. Surgical
      removal is still the treatment of choice. Over the years, various treatment strategies such
      as simple excision with or without adjunctive measures (eg, postoperative [beta]-irradiation,
      intraoperative, and/or postoperative mitomycin C) and various techniques of conjunctival
      grafting have been tried to decrease recurrence after surgery. Conjunctival autograft and
      amniotic membrane transplantation are commonly used methods. However, they are time-consuming
      techniques because the graft must be fixed, usually by sutures. Tissue adhesives provide
      alternative ways for attaching conjunctival grafts and may shorten operating time, diminish
      postoperative discomfort, and remove suture-related complications. Using tissue adhesive
      instead of sutures results in shorter operation time. It has been reported by several
      studies. Furthermore, it seems also contributed to lower recurrence rate. National Taiwan
      University Hospital (NTUH), as one of the largest tertiary medical centers in Taiwan, is now
      in charge of a big part of difficult cases of ocular surface, including the refractory
      pterygium. With the previous experiences reported, the investigators are competent for this
      meaningful program to evaluate the effect and benefit of fibrin adhesives in external eye
      disease.
    

Intervention name(s): Fibrin Glue assisted external eye surgery; Fibrin glue
Intervention type(s): Procedure; Device
Intervention MeSH terms: Fibrin Tissue Adhesive
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: corneal ulcers; conjunctival closure in strabismus surgery; surgery for retinal detachment; cataract surgery; mucous membrane grafting