Simplified Technique for Sealing Corneal Perforations Using a Fibrin Glue-Assisted Amniotic Membrane Transplant-Plug

Abstract

Purpose. To describe a surgical technique using amniotic membrane transplant (AMT) with fibrin glue (FG) for treating smaller corneal perforations more practically and appropriately filling the defect. Method. A patient with noninfectious central corneal perforation, in 1 mm in diameter, was treated with FG-assisted AMT-plug. An AMT was folded in on itself twice by using FG then a small piece of this FG-AMT mixture was cut to maintain an appropriate plug for the site of the corneal perforation. The FG-assisted AMT-plug was placed in the perforation area by using FG. An amniotic membrane patch was placed over the plug, which was then secured by a bandage contact lens. Result. Surgery to restore corneal stromal thickness without recurrence of perforation. Conclusion. The FG-assisted AMT-plug allowed a successful repair of 1 mm in diameter corneal perforation. This technique was easily performed, thus seeming to be a good alternative to treat corneal perforations with restoring corneal thickness.

Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations

“…ey also recommended against multilayered AMTs for permanent wound closure in corneal perforations involving the optical axis because the central cornea can become cloudy, with the final visual result requiring optical keratoplasty. Multilayered AMTs are a useful tool in the management of corneal ulceration or perforation to restore corneal integrity and to minimise the risk of corneal grafts [13,17,19]. In our series, we also preferred AMTs because of the lower risk of complications and their ability to promote epithelial healing at the core of the corneal melting.…”

“…e MMPs are shown to have a role in infectious and noninfectious causes of corneal tissue destruction [9][10][11]. e management and timing of corneal melting, ulceration, and consecutive perforation depends on the cause, size, corneal infiltration, location of perforation, and status of other ocular tissues [12,13]. Nonsurgical treatments include reducing inflammation, addressing the underlying cause, using anticollagenases, treating coexistent infections, prescribing antiglaucoma treatments, and optimising epithelial healing (using bandage soft contact lenses, autologous serum eye drops, or lacrimal punctal occlusions).…”

Fibrin matrices: The versatile therapeutic delivery systems

“…Transforming Growth Factor β1 [10,11] Platelet-Derived Growth Factors (PDGF-BB, AB) [12,13] Insuline Like Growth Factor (IGF-1) [12] Interleukin-1β [14] Epidermal Growth Factor (EGF) [15] Enzymes/proenzymes Plasminogen [16] Tissue Plasminogen Activator (tPA) [16] Plasminogen Activator Inhibitor [17] Thrombin [18] Neomycin, Gentamicin, Polymyxin E in vitro [81] Cephalotin in vitro and in vivo [82] Cefotaxime in vivo [83] Metranidazole, Bacitracine in vivo [84] Cefoxitin, Gentamicin in vivo [85] Tobramycin in vitro and in vivo [86] Gentamicin derivative in vitro and in vivo [87] Ceftazydime,Tobramycin, Gentamicin,Clindamycin, Ampicillin in vitro [88] Teicoplanin,Ciproflaxacin, Cefoxitin, Gentamicin in vitro [89] Gentamycin derivative in vitro and in vivo [90] Clindamycin, Cefotaxime in vivo [91] Sisomicin in vivo [92] Neomycine in vivo [93] Cifroflaxacin in vitro and in vivo [94] Ampicillin, Debakacin, Gentamicin, Carbenicillin, Ceftazidin, Cefoxitin, Cefoxitin, Polymixin B, Mupirocin, Norflaxacin,Clindamycin,Nitrofurazone in vitro [95] Oflaxacin, Ampicillin, Gentamicin in vitro [96] Abrekacin sulfate in vitro and in vivo [97] Vancomycin, Cephalothin, Gentamicin, Teicoplanin in vitro and in vivo [98] Tetracyclin in vivo [58] Tetracyclin in vitro and in vivo [31] Tetracyclin in vitro [36] Ceftazidime, Moxifloxacin, Lomefloxacin,Vancomycin in vivo [99] Vancomycin in vivo [100] …”

Outcomes of Amniotic Membrane Transplantation in Corneal Surface Diseases

“…3 Korneal mikroperforasyonlarda siyanoakrilat ile AZ'ın başarılı kombinasyonu yanında, son zamanlarda AZ ve fibrin yapıştırıcı kombinasyonu ile AZ tıkaç veya kuvvetlendirilmiş AZ (5-7 kat AZ) uygulamaları da bildirilmiş-tir. 9,10,13,14 Bu tür hastalarda AZ'ın antineovas küler etkisinin de muhtemel kornea nakli ameliyatının başarısını artırdığı savunulmaktadır. 15 Aykut ve ark.…”