November 6th, 2011 | 
Author: November 6, 2011
Doctor Engel’s Blog – Bioadhesives in scleral ruptures
Have you ever tried to get a ruptured globe watertight in the middle of the night? I have – and it’s not always easy. Suturing a scleral laceration or watching a resident try can test your patience, especially in posterior, jagged wounds. BioGlue can help. Cardiac surgeons use it to seal leaking bypass graft anastamoses. You can spray it on a leaking scleral wound. It has the consistency of rubber cement – and it goes on like an epoxy. A handy double-barreled syringe applicator applies the adhesive precisely. It sets in around 20 seconds to give a tight seal.
BioGlue has two components: bovine albumin and glutaraldehye. The mixtures bonds rapidly to tissue, and leaves no significant inflammatory reaction. It’s neuro-toxic so keep it away from nerve and retina. The most noteworthy (rare) complications have involved paralysis of the phrenic nerve in cardiac surgery. One report has championed its utility in eye trauma.
BioGlue is more useful than Dermabond or Tisseel, which are too runny for posterior wounds. Neither Dermabond nor Tisseel can be easily applied to wounds at or behind the equator. Tisseel may be useful in the anterior globe – but it takes about two minutes to set.
- Harry M. Engel, MD
Ref: Repair of a Ruptured with BioGlue & Imbrication. Engel, et al. Retina 2007 Apr-May; 27(4):505-508.
For further information contact: drengel@westsideretina.com
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