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Bulgarian Review of Ophthalmology

Autologous fibrin glue in double perforating injuries of the eyeball

Ilian Shandurkov, Ivan Tonev


Aim: The aim of this article is to demonstrate the method of eyeball-sparing surgery in double perforating trauma, after a gunshot wound.

Materials and Methods: Three patients with double perforating wounds of the eyeball as a result of a gunshot are presented. The primary surgeries of the anterior segment of the eye were performed by revisions and simple sutures. After a period of 14 to 60 days we performed posterior segment surgeries. The fibrin glue was made of autologous blood, after extraction of its fibrinogen. The tissue sealant was used in all three patients with perforation of the eyeball in the posterior pole. At the end of the vitrectomy in all cases, a silicone oil was implanted as a measure for permanent maintenance of the intraocular pressure.

Results: Sufficient adaptation of the wound in the posterior pole was achieved in all three patients. In all of them there was severe traumatic retinopathy and even loss of retina in some quadrants. In the follow-up period of 6 months to 5 years, we did not found leakage of silicone oil towards orbital structures. Visual acuity was from insecure light perception to full absence of light sensitivity. Esthetically, the eyeball remained with its full volume and mobility.

Conclusion: Autologous fibrin glue provides stable permanent occlusion after trauma with significant loss of tissue in the posterior pole of the eyeball, where it is impossible to place sutures.


autologous fibrin glue; double perforating injuries; eye-saving surgery

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About The Authors

Ilian Shandurkov
VISION Eye Hospital, Sofia

Ivan Tonev
Laboratory for Cell and Gene Therapy, National Center of Hematology - Sofia