Cataract Clinical Trial
Official title:
The Application of Fibrin Glue (Tissucol Duo Quick) in External Eye Surgeries
The fibrin sealants are prepared from fibrinogen, thrombin, and sometimes factor XIII that have been purified from human plasma. Tissucol Duo Quick (Baxter, Vienna, Austria) is a kind of fibrin sealants with popular use. It is a 2-component tissue adhesive that resembles natural fibrin formation. This glue has 2 components: fibrinogen (mixed with factor XIII and aprotinin) and thrombin-CaCl2 solution. When equal amounts of the 2 components are mixed, the monomers aggregate by cross-linking, resulting in a fibrin clot. It forms a elastic, whitish substance and provides strong adhesion to the tissue. Therefore, it is a good agent to seal small wounds or to replace the use of suture.
Biologic adhesives have been used in medicine for many years. It has been applied to
numerous surgical fields. As for the ophthalmic field, The use of organic glues has provided
good results for the repair of leaking blebs and perforated corneal ulcers, conjunctival
closure in strabismus surgery, surgery for retinal detachment, cataract surgery,
trabeculectomy, and mucous membrane grafting to repair lesions of the conjunctival fornix.
The fibrin sealants are prepared from fibrinogen, thrombin, and sometimes factor XIII that
have been purified from human plasma. Tissucol Duo Quick (Baxter, Vienna, Austria)is a kind
of fibrin sealants with popular use. It is a 2-component tissue adhesive that resembles
natural fibrin formation. This glue has 2 components: fibrinogen (mixed with factor XIII and
aprotinin) and thrombin-Calcium Chloride solution. When equal amounts of the 2 components
are mixed, the monomers aggregate by cross-linking, resulting in a fibrin clot. It forms a
elastic, whitish substance and provides strong adhesion to the tissue. Therefore, it is a
good agent to seal small wounds or to replace the use of suture.
Pterygium is a triangular-shaped growth of abnormal conjunctival tissue that extends
horizontally from the bulbar conjunctiva, across the limbus, and onto the cornea. Surgical
removal is still the treatment of choice. Over the years, various treatment strategies such
as simple excision with or without adjunctive measures (eg, postoperative
[beta]-irradiation, intraoperative, and/or postoperative mitomycin C) and various techniques
of conjunctival grafting have been tried to decrease recurrence after surgery. Conjunctival
autograft and amniotic membrane transplantation are commonly used methods. However, they are
time-consuming techniques because the graft must be fixed, usually by sutures. Tissue
adhesives provide alternative ways for attaching conjunctival grafts and may shorten
operating time, diminish postoperative discomfort, and remove suture-related complications.
Using tissue adhesive instead of sutures results in shorter operation time. It has been
reported by several studies. Furthermore, it seems also contributed to lower recurrence
rate. National Taiwan University Hospital (NTUH), as one of the largest tertiary medical
centers in Taiwan, is now in charge of a big part of difficult cases of ocular surface,
including the refractory pterygium. With the previous experiences reported, the
investigators are competent for this meaningful program to evaluate the effect and benefit
of fibrin adhesives in external eye disease.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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