Clinical Effects Review Of Obstruct Lacrimal Canaliculi With Fibrin Glue.

Objective: To observe the method and efficacy for obstructing lacrimal canaliculi with fibrin glue.Methods: Fibrin glue consists of two parts that, when mixed, mimic natural clot formation. One part consists of human fibrinogen, whereas the other part consists of human thrombin. The two parts are abstracted to two syringes, which are put in a equipment.The equipment are fixed a Y-shaped converter and the two parts can be pour in low lacrimal punctum through it. When the two parts are combined, the final stages of the coagulation cascade are initiated, and a strong, dense, cross-linked fibrin glue formed about one minute. It can substitute dissolvable canaliculus lacrimalis plug. Fibrin glue was applied in 47 patients(94 eyes) under the slit lamp microscope. Questionnaire was used in these patients before the surgery 3 days and repeated after surgery 3 days, 1 week,2 weeks and 3 weeks. Slit lamp microscope examination, fluorescent staining,tear break-up time (BUT) , Schirmer testⅠ( STⅠ) were carried out at the same time.Results: Fibrin glue be poured into canaliculus lacrimalis aim to retain tear. Questionnaire:prior treatment the score was 45.26±5.52,post-treatment of 3days,1 week,2 week,3 week,the score was differently 36.72±3.56,27.59±3.21,25.65±3.54,42.94±4.65. Post-treatment the score of all patients decreased in 2 weeks ,P<0.01; Slit lamp micrography:2w of post-treatment,the lacrimal river of all patients became broad.But the lacrimal river become narrow again at third week; FL:The the grade of cornea color were improved after 1 week,and the sign did not recur at third week. Schirmer test I and BUT test: the value was improved after 2 week,P<0.01.But they are recur at third week. The lacrimal drainage system is patent on irrigation from low punctum.The fibrin glue was obsorbed in 3 weeks. Complication,such as ensitization, forein-body sensation, Inflammatory reaction and scarring,is not occur. 6 eyes happened epiphora,relieved after 2 weeks.Conclusion: Symptoms of patients suffered from dry eye were relieved obviously by using fibrin glue to obstruct lacrimal canaliculus in short term.Therefore the method can be used for patients with serious dry eye by improving tear volume and tear film stability.Tamponade of the lacrimal drainage system is a simple procedure that is underused,appear to be safe and effective. Fibrin glue can spontaneously be dissolved so can substitute dissolvable plugs to obstruct lacrimal canaliculus.