Fibrin glue for opposing wound edges in "Top Hat" penetrating keratoplasty: a laboratory study

Abstract

Purpose: To evaluate the advantages of fibrin glue for opposing wound edges in Top Hat penetrating keratoplasty (PKP).

Methods: Twenty human corneoscleral rims were mounted on an artificial anterior chamber. Eight corneas underwent traditional PKP, 6 underwent Top Hat PKP, and 6 underwent Top Hat PKP by using fibrin glue for opposing wound edges. Mechanical stability was evaluated after placement of 8 and 16 interrupted sutures. Wound bursting pressure and induced astigmatism were evaluated.

Results: In the traditional PKP group, wound bursting pressure was 25.2 and 59.1 mm Hg after placement of 8 and 16 sutures, respectively. In the Top Hat PKP, leakage occurred at 57.6 and 103.8 mm Hg after placement of the 8 and 16 sutures, respectively. In the Top Hat PKP + fibrin glue group, wound leakage occurred at 144.6 mm Hg after placement of the 8 sutures and at >158 mm Hg after placement of 16 sutures. The Top Hat PKP + fibrin glue group induced astigmatism of 2.5 D, whereas the traditional PKP group and the Top Hat PKP group showed an induced astigmatism of 3.1 D each.

Conclusions: The use of fibrin glue in Top Hat PKP was found to be more mechanically stable than traditional sutures.