조직접착제를 이용한 무봉합 표층각막이식 및 라식 각막판 복원 증례

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 ShaperTM (ACSTM). 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.