A biologic tissue adhesive for vitreoretinal surgery

Abstract

Commercially available tissue glue was injected subretinally under mechanically induced retinal detachments in rabbit eyes resulting in chorioretinal adhesions at the injection site. After serial enucleation all eyes underwent histologic evaluation. Results were encouraging, but pooled fibrinogen is not acceptable for human use. A substitute for the pooled fibrinogen fraction, an adhesive using autologous plasma was prepared and studied after subretinal and intravitreal injection into rabbit and pig eyes. Postoperative clinical follow-up was one year for the rabbit eyes and one month for the pig eyes, after which all globes were enucleated. Histopathologic evaluation demonstrated circumscribed chorioretinal adhesions at the injection site. The autologous bioadhesive was applied as an adjunct in vitreoretinal surgery over macular holes and large retinal tears. As it is relatively short acting (ie, 4-6 days), it may be considered as a possible addition to existing techniques, facilitating difficult surgical procedures.