J Korean Ophthalmol Soc.  2005 Oct;46(10):1741-1746.

Lamellar Keratoplasty and Restoration of Traumatic Dislocation of LASIK Flap Using Human Fibrin Adhesive

• Lim TH
• Kim MJ
• Kim TI
• Tchah HW

Abstract

PURPOSE
To report two cases of sutureless corneal surgery performed with human fibrin sealant: lamellar keratoplasty and revision of traumatic LASIK flap dislocation. METHODS: In one case, lamellar keratoplasty was performed because of corneal opacity in the anterior stroma, which occurred after herpes simplex keratitis. Free flaps were made in donor and recipient corneas using an Automated Corneal Shaper(TM) (ACS(TM)). After human fibrin sealant was applied to the surface of the recipient's stromal bed, the donor's corneal flap was attached to the bed. The other patient evaluated had partial dislocation of the LASIK flap following trauma. The corneal epithelium covered the lifted and wrinkled corneal flap. The epithelium was removed after applying 20% alcohol. Then, the flap was repositioned and fixed using human fibrin sealant. RESULTS: At postoperative 3 months, clarity and integrity were maintained without serious complications. Visual acuity was improved in both cases. However, an additional procedure was needed in the case of LASIK flap revision because of epithelial ingrowth. CONCLUSIONS: Human fibrin sealant is an effective tool for corneal surgery and is advantageous because it does not require sutures. However, further studies that involve a large number of patients and a longer follow-up period are required to validate its universal use.

Keyword

Human fibrin sealant; Lamellar keratoplasty; LASIK flap

MeSH Terms

Cornea
Corneal Opacity
Corneal Transplantation*
Dislocations*
Epithelium
Epithelium, Corneal
Fibrin Tissue Adhesive*
Fibrin*
Follow-Up Studies
Free Tissue Flaps
Humans*
Keratitis, Herpetic
Keratomileusis, Laser In Situ*
Sutures
Tissue Donors
Visual Acuity
Fibrin
Fibrin Tissue Adhesive