Sutureless transplants could be possible

The sutureless method of transplantation of fibrin glue-coated, freeze-dried amniotic membrane (FCFD-AM) is both safe and straightforward, according to a study published in the April issue of Investigative Ophthalmology and Visual Science.

Eiichi Sekiyama and colleagues from the Kyoto Prefectural University of Medicine and Doshisha University, Japan and Lancaster University, UK made a bioadhesive-coated, freeze-dried amniotic membrane (AM). This was achieved by freeze drying the AM in a vacuum and applying the minimum amount of fibrin glue necessary to retain adhesion on the chorionic side and by sterilizing it by radiation. The resulting AM was characterized for its biological and morphological properties by immunohistochemical and electron microscopic examination. The FCFD-AM was transplanted onto a rabbit scleral surface, without sutures, to examine its biocompatibility.

Immunohistochemistry revealed that fibrinogen existed on its chorionic side and that the process of applying fibrin glue did not affect its biological and morphologic properties. Electron microscopic examination of the chorionic side, revealed tiny microfibrils and showed that the epithelial surface of FCFD-AM consists of intact basal lamina similar to that of FD-AM.

The transplantation was straightforward and the graft adhered to the bare sclera instantly. Although the fibrinogen naturally biodegraded within two weeks, the FCFD-AM remained for at least 12 weeks after transplantation. The conjunctival epithelium on the FCFD-AM was well stratified and not keratinized, indicating that it supports normal cell differentiation.

The authors concluded that FCFD-AM could be a relatively safe and simple method of ocular reconstruction.