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Abstract #27944 Published in IGR 13-1
Free electron laser-treated tisseel enhances closure of trabeculectomy leaks
Joos K; Shen J; Robinson R; Prasad RLasers in Surgery and Medicine 2009; 41: 70
Background: The free electron laser (FEL) at Amide Band III wavelength (7.7 mm) has been shown to enhance tissue glue (Tisseel) congealment and adherence. This project evaluates FEL (7.7 mm) enhanced congealment of Tisseel combined with subconjunctival injection of fibroblasts to seal trabeculectomy leaks. Study: A trabeculectomy was performed in the right eye with a 1.5 mm diameter leaking hole created in the conjunctival bleb in 13 pigs. Tisseel was applied in and over the wound with 50% randomized to 7.7 (mu)m FEL irradiation (30 Hz, 370 mm diameter spot size, 2 mJ). CoSeal surgical sealant was then applied, and 500,000 cultured YFP-transfected porcine fibroblasts were injected subconjunctivally. Intraocular pressure (IOP) was measured before and after the procedure. Two days later, the procedure was performed acutely in the left eye, and the previously treated bleb in the right eye was inspected prior to euthanasia and enucleation. The globes were examined, and the tissues processed for histology. Results: Mean intraocular pressures (IOP) were 19+3.3 mm Hg preoperatively, 6+2 mm Hg immediately postoperatively, and 8+3.8 mm Hg 2 days postoperatively. The materials coated all bleb holes acutely. No holes leaked on postoperative day 2. However, 4/6 (67%) of the non FEL-treated blebs compared to 2/7 (29%) of the FEL-treated blebs had only a thin covering over the hole. YFP-labeled fibroblasts were observed subconjunctivally in both acute and postoperative day 2 eyes. Histologically, Tisseel and CoSeal were observed to cover the holes in the acute eyes. Conclusion: In a porcine model of trabeculectomy bleb holes, more complete healing was present on postoperative day 2 after low 7.7 (mu)m FEL energy irradiation of Tisseel. Injected YFP-labeled fibroblasts remained present at postoperative day 2. LA: English
K. Joos. Vanderbilt Eye Institute, Nashville, United States.
Classification:
15 Miscellaneous
12.20 Other (Part of: 12 Surgical treatment)
