[An update on the use of tissue adhesives in ophthalmology]

Abstract

Tissue adhesives have a long history of use in almost all surgical disciplines, both as an alternative and a complement to sutures. Nevertheless, ophthalmologists have restricted knowledge of their potential applications; consequently, tissue adhesives have been underutilized so far. This review discusses the most relevant clinical and experimental advances in the use of tissue adhesives in ophthalmology and details the characteristics and properties of the glues. Among the currently available adhesives, synthetic glues are mainly represented by cyanoacrylates and biologic glues by fibrin-based adhesives. Cyanoacrylate-based glues are especially useful for treating perforated or preperforated corneal ulcers and performing temporary tarsorrhaphy. Fibrin-based glues have the largest field of application, as they can be used in corneal perforations and are being widely used in pterygium surgery and conjunctival surgery. We also reviewed other anecdotic applications of these adhesives. Novel biomaterials such as biodendrimers, polyethylene glycols, modified chondroitin sulfates, and acrylic copolymers show promising results in the experimental field, and one product has been on the market for a short period of time.