| The medical adhesive belonged to one special functionality tackifier of biomedicine, It should have the function of biomedicine beside those common functions of mastic and mechanics. Nationally, we called those medical production which would contact with the human body physiological environment (tissue & blood ,etc.) direttly as biomedical engineering material , the medical adhesive belonged to one of them.Cyan- oacrylate adhesive and fibrin sealant are the most commonly used tissue adhesive at present. N-Octyl-Cyanoacrylate/ N-Butyl-Cyanoacrylate belon- ged to cyanoacrylate adhesive, it was composed of high purity N-OCA and N-BCA,At present, because of its abundant special property,it have already been commonly used in liver spleen surgery,heart blood,vessel surgery,neu- rosurgery and otorhinolaryngology ,and was proved have no toxicty,no 3 le- ads(mutation,deformity,cancer),no haemolysis,no heat source,etc. But beca- use the eyeball have complex structure and individual function,especially, it was sensitive to all various kinds of stimulus causd by physics and chemist- ry factor and very easy to be damaged,so it was seldomly applied in ophth- almology.We want to study the influence on histopathology,ultrastructure,apoptosis of the cells after the trabeculectomy with N-OCA/N- BCA;evalu- ate its histocompatibility on the ocular tissue; investigate its feasibility and security on glaucoma &ocular surface surgery;evaluate the surgical techn- ique method and its clinical effectiveness in trabeculaectomy.This study provide experiment foundation for the application of N-OCA/N-BCA in ophthalmology, and provide new method for the evaluation of the ophtha- lmology operation and the development of new operation.PARTâ… THE ALTERATION OF OCULAR HISTOPATHOLOGY IN TRABECULECTOMY WITH THE USE OF CYANOACRYLATEObjective: To study the influence on histopathology,ultrastructure,apoptosis after the trabeculectomy with N-OCA/N-BCA;evaluate its histocompatibility on the ocular tissue; investigate its feasibility and securi- ty on glaucoma &ocular surface surgery through animal experiment. Methods: Constructed the animal model through imitating the trabeculect- omy, squashed the N-OCA/N-BCA along the wound borderline and under the scleral flap, pasted the flattened scleral flap quickly on the dissected bed. After surgery we observed the eye by slit lamp microscope every day, and on the 3rd day,7th day,15th day,30th day we study the eye through these 4 aspects: histopathology,assaying the apoptosis cells by TUNEL,staining the corneal endothelial cells,observeing the ultrastrcture of the retina,iris and ciliary body. We devided those animales into 3 groups:502 glue group,simple dissected group and suture line group to contrast among each group. Results:On the 3rd day,7th day,15th day,30th day postoperatively, and simple dissected group have no significant difference in those 4 aspects and the percentage of survival corneal endothelial cells of the N-OCA/N-BCA group were all above 93%,this indicated that N-OCA/N-BCA was no poisonous to the corneal endothelial cells; On the 7th day,15th day, of the N-OCA/N-BCA group,the scleral flap haven't been healed but of the suture line group,it already have been healed;On the 30th day, the healing extent of the scleral flap of the N-OCA/N-BCA group was similar with the suture line group on the 15th day;The difference of collagenoblast counting (tested by light microscope)within filtration tunnel between the N-OCA/N-BCA group and the suture line group was significant (P>0.05);The collagenoblast began to gradually increase on 15th day and 7th day of the N-OCA/N-BCA group and the suture line group respectively, and have been obviously risen on 30th day and 15th day respectively.Conclusion: The N-OCA/N-BCA are satisfactory histocompatibility materials and can delay the concrescence of scleral flap in trabeculectomy. It have been proved that it can be safely and feasiblely used in the glaucoma &ocular surface surgery. PARTâ…¡THE CLINICAL STUDY ON CYANOACRYLATE IN TRABECULECTOMYObjective: To observe and approach the method and clinical effectiveness in using N-OCA/N-BCA to stick scleral flap in trabeculaectomy. Methods: We choosed prospective-clinical-contrast study, randommisely devided those 40 patients who would receive the glaucoma trabeculectomy into 2 groups: 20 patients(25 eyes) in the bonding group, 20 patients(28 eyes) in the sutures group. We evaluated the benefits of them with respect to surgical effects,responses,complications,IOP,Vision,field of vision and so on,analysis the results in statistical way by SPSS12.0.Results: Following up 6-24 months. Compared the bonding group(25 eyes of 20 cases) with the sutures group(28 eyes of 20 cases), the difference of the postoperative intraocular pressure was not statistical significant(P>0.05 );3 eyes in bonding group needed drugs to keep normal IOP after 1 month, nevertheless ,2 eyes needed drugs keep normal IOP in sutures group after 7 day,but one of them failed in this way,and it took the second surgery in the sixth month.The eyes in two groups mainly tended to form typeâ…¡blebs according to Kronfeld[1] classification, the functionality filtration bleb was 84% and 82.15% in bonding group and sutures group respectively, the sutures group and the bonding group were not significant difference in typeâ… and typeâ…¡blebs(P>0.05).The occurrence rate of shallow anterior chamber was 16% and 7.1% in bonding group and sutures group respectively, the un-formation of filtration pad rate was 0% and 14.3% respectively,anterior chamber hyphema rate was 4% and 3.6% respectively. There wasn't any ablatio chorioidea or other complications in both groups. Nearly no changes happened in the vision and the visual field of all the cases after operation, statistical significance haven't been observed.Conclusion: The using of N-OCA/N-BCA instead of sutures in trabe-culaectomy simplifies the surgical procedur and makes the surgery sa- fe,and can surpass sutures to some extent. It is worth spreading and studying for clinical use.
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