Assessment of the Retinal Toxicity and Sealing Strength of Tissue Adhesives.

PURPOSE: The purpose of this in vitro prospective nonrandomized study is to compare the toxicity and strength of cyanoacrylate and hydrogel adhesives on human retinal pigment epithelium (RPE) cells and porcine retina, respectively.

METHODS: The toxicity of cyanoacrylate (histoacryl, dermabond, superglue), ReSure PEG, and Tisseel fibrin glue on human RPE cells was determined by growing RPE cells in vitro, applying the different adhesives to the cells, and monitoring for disruption of growth over 3 days. The relative strength of these adhesives was tested by gluing a 3 mm piece of foam to a porcine retina and determining the amount of force needed to break the attachment.

RESULTS: 0.085 N of force was required to break the porcine retinal tissue ( p = .913). Histoacryl adhesive exhibited high strength (0.247 N) and high RPE toxicity (0.55 mm inhibition zone after 24 hrs). The strength of Tisseel fibrin glue was 0.078 N while that of ReSure was only 0.053 N. Both Tisseel and ReSure were nontoxic to the RPE cells.

CONCLUSIONS: Tisseel VH fibrin sealant may provide the best option for sealing retinal breaks because of its high strength and low retinal toxicity.