Rapid preparation of small volume autologous fibrinogen concentrate and its same day use in bleb leaks after glaucoma filtration surgery

The authors evaluated small-volume preparation of autologous fibrin glue (A FG) and same day use in postglaucoma filtration surgery patients with Seide l positive bleb leaks and determined fibrinogen concentrations in autologou s fibrinogen concentrates (AFCs) from 10 volunteers. Thirty milliliters of blood was centrifuged (5 min, 2400 x g); plasma was frozen (5 min-ethanol a nd ice), thawed (1-6 C, 30-60 min), and centrifuged (10 min, 5 C, 2800 x g) ; and the precipitate was transferred to a 1.0-ml tuberculosis syringe. Thr ombin (1000 U) was dissolved (0.8 sterile water, 0.2 mi aminocaproic acid) and warmed (37 C). Average preparation time was 90 minutes. Alternating dro ps of AFC and thrombin were applied to bleb leaks until AFC clotted. Seidel testing with fluorescein determined success. AFC was prepared from 10 volu nteers and fibrinogen was measured. AFG was initially successful with two ( Seidel negative) eyes; one eye remained negative. AFG was unsuccessful in o ne briskly Seidel-positive leak. Mean +/- SD fibrinogen concentration in AF Cs from the 10 volunteers was 2314 +/- 643 mg/dl (range 1608-3431 mg/dl). A FG may successfully close bleb leaks in outpatient settings. Brisk aqueous flow may impair effectiveness of AFG. Fibrinogen concentrations were compar able with previous reports.