What is fibrin adhesive?
Fibrin adhesive: This is a two component product which we purchase and use to help the fibrin cascade – so that is the thrombin formation cascade that occurs with healing.
Now that sounds very technical, but as you realise that when I do your upper eyelid surgery and your lower eyelid surgery, I have to cut through the skin, very delicately, to remove a little bit of it. And then I have to reposition the skin edges together. So I have the option of using stitches or I can entirely use fibrin adhesive. It is like a glue, but it isn’t a glue, because it relies on contact with your fibrin that occurs in the wound to cause coagulation and just beautifully seal that wound very quietly (helps it be a very quiet nice wound) that helps the healing. It also gives you a wonderful appearance afterwards, because you have hardly any sutures.
In the year 2003, I applied to the Ethical Committee at St. Mary’s Hospital, part of Imperial College, to do a randomised controlled study of a tissue adhesive with wound closure, with ptosis, and upper eyelid blepharoplasty. In other words, with eyelid surgery. And we did about 30 patients in whom we used very, very few sutures. And we had two masked observers, who looked to the healing photographs afterwards and found that they were as good as stitches or in fact, slightly better and had very good patient satisfaction for the wound healing in the recovery afterwards.
So this is something I was the principal investigator of and I am pleased to say, that I am one of the few people that are able to use this. We weren’t able to use this for a few years, because it was prohibitively expensive and it was quite complex. We had to mix the two products together, but now the prices are more reasonable for patients, and it is easier as they come pre-mixed, and so we are using it a lot more.
And our feedback from our patients, is that they are very pleased, by not having to have a lot of stitches. It means not so much time spent underneath the surgery and a quicker recovery.
More about Jane Olver
Ms Jane Olver is the founder of Clinica London and a Consultant Ophthalmologist and Oculoplastic Surgeon. Her special expertise is in oculoplastic and cosmetic eye surgery including eyelids and lacrimal surgery. She is specialised in endoscopic lacrimal surgery for watering eyes in adults and children. She has over 20 years’ experience in treating people with eye problems just like you, and has published extensively in scientific journals about Ophthalmology and Lacrimal Surgery and is the author of the books “Ophthalmology at a Glance” and “Colour Atlas of Lacrimal Surgery”. At Clinica London, she is responsible for the Aesthetic Medicine and Surgery part, as well as patients with eye, eyelid and tear duct problems, and acute eye problems.