Fibrin glue inhibits migration of ocular surface epithelial cells

Abstract

PurposeFibrin glue has been used successfully in numerous ophthalmic surgical procedures. Recently, fibrin glue has been used in limbal stem cell transplantation to reduce both operative time and to negate the need for sutures. The aim of this study was to determine the effects of fibrin glue on epithelial cell migration in vitro.MethodsCorneoscleral rims were split to retain the epithelial layer, Bowman's layer, and anterior stroma. Rims were cut into eight equal-sized pieces and were placed directly on culture plates or affixed with fibrin glue. Rims were maintained in culture for 25 days and epithelial cell growth was monitored. Cells were photographed to measure area or growth and immunofluorescence staining of explants for fibrin was performed.ResultsExplants that were glued demonstrated significantly delayed epithelial cell growth and migration as compared with explants without glue. By day 16, all fibrin glue had dissolved and coincided with onset of cell growth from glued explants. Cell growth commenced between days 3 and 4 for control explants without glue and around days 14-16 for explants with fibrin glue.ConclusionsFibrin glue delays epithelial cell migration by acting as a physical barrier and can potentially interfere with explant-derived limbal epithelial cell migration on to the corneal surface. We propose that glue should be used to attach the conjunctival frill of the limbal explant but care should be taken to ensure that the glue does not wrap around the explant if used to secure the explant as well. Strategic use of glue, to attach the recessed conjunctiva, can be advantageous in delaying conjunctival cell migration and reducing the need for sequential sector conjunctival epitheliectomy.

Healing of autologous conjunctival grafts in pterygium surgery

“…Fibrin glue has been shown to mechanically interfere with epithelial cell migration which proceeds normally once the glue dissolves in 10-14 days (Yeung et al 2016). Fibrin glue has been shown to mechanically interfere with epithelial cell migration which proceeds normally once the glue dissolves in 10-14 days (Yeung et al 2016).…”

“…The epithelial migration too could have been influenced by the fibrin glue applied (Yeung et al 2016). This represented a retraction of the tissue, exposing the sclera/ episclera.…”

Amnion-assisted conjunctival epithelial redirection in limbal stem cell grafting

“…This can be delayed by the use of fibrin glue to attach the conjunctiva on to AM. Fibrin glue is known to mechanically interfere with the migration of cells, which starts only when the glue has lysed 30. In most cases the redirecting sheet of amnion begins to fall off between week 1 and 3 by which time the cornea is substantially resurfaced by limbal explant-derived epithelium, making ingress of conjunctival epithelial cells much less likely due to contact inhibition.…”

Simple limbal epithelial transplantation: Current status and future perspectives

“…Kheirkhah and colleagues suggested that the glue forms a full contact seal between the transplanted AM and the corneal surface, ensuring reepithelialization occurs on the surface of the AM rather than underneath, taking full advantage of the AM microenvironment . in vitro work has shown that fibrin glue inhibits cell migration, which in SLET may prevent ingrowth of conjunctival tissue at a critical phase and promote expansion of epithelial cells from explants on the AM surface . Growth rates vary between explants from the same donor placed in the same eye, which may be attributed to the amount of fibrin glue used for their individual attachment or to differences in handling during transplant .…”

“…57 in vitro work has shown that fibrin glue inhibits cell migration, which in SLET may prevent ingrowth of conjunctival tissue at a critical phase and promote expansion of epithelial cells from explants on the AM surface. 58 Growth rates vary between explants from the same donor placed in the same eye, which may be attributed to the amount of fibrin glue used for their individual attachment or to differences in handling during transplant. 4 Fibrin glue has also been shown to extend the beneficial effects of AM by delaying its breakdown compared with sutures.…”