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Surgical adhesives in ophthalmology: history and current trends
  1. Samantha Guhan1,
  2. Si-Liang Peng2,3,
  3. Hrag Janbatian1,2,3,
  4. Stephanie Saadeh2,
  5. Stephen Greenstein3,
  6. Faisal Al Bahrani2,4,
  7. Ali Fadlallah1,2,3,5,
  8. Tsai-Chu Yeh2,6,
  9. Samir A Melki1,2,3
  1. 1Harvard Medical School, Boston, Massachusetts, USA
  2. 2Boston Eye Group, Boston, Massachusetts, USA
  3. 3Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
  4. 4Boston University, Boston, Massachusetts, USA
  5. 5Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
  6. 6University of California, San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Samir A Melki, Cornea and Refractive Surgery Service, Massachusetts Eye & Ear Infirmary, Boston, MA 02114, USA; samir_melki{at}meei.harvard.edu

Abstract

Tissue adhesives are gaining popularity in ophthalmology, as they could potentially reduce the complications associated with current surgical methods. An ideal tissue adhesive should have superior tensile strength, be non-toxic and anti-inflammatory, improve efficiency and be cost-effective. Both synthetic and biological glues are available. The primary synthetic glues include cyanoacrylate and the recently introduced polyethylene glycol (PEG) derivatives, while most biological glues are composed of fibrin. Cyanoacrylate has a high tensile strength, but rapidly polymerises upon contact with any fluid and has been associated with histotoxicity. Fibrin induces less toxic and inflammatory reactions, and its polymerisation time can be controlled. Tensile strength studies have shown that fibrin is not as strong as cyanoacrylate. While more research is needed, PEG variants currently appear to have the most promise. These glues are non-toxic, strong and time-effective. Through MEDLINE and internet searches, this paper presents a systematic review of the current applications of surgical adhesives to corneal, glaucoma, retinal, cataract and strabismus surgeries. Our review suggests that surgical adhesives have promise to reduce problems in current ophthalmic surgical procedures.

  • treatment surgery
  • wound healing
  • cornea
  • retina
  • glaucoma

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Footnotes

  • Contributors SAM had the original idea for the article and is the guarantor. All other authors were involved in literature search, drafting, revising and final approval of the document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There is no additional unpublished data from this study.

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