Bahar Irit, Weinberger Dov, Gaton Dan D, Avisar Rahamim
Department of Ophthalmology and External Eye Disease Clinic, Rabin Medical Center, Beilinson Campus, Petah-Tiqwa 49 100, Israel.
Curr Eye Res. 2007 May;32(5):399-405. doi: 10.1080/02713680701294723.
To compare the long-term results of conjunctival closure with fibrin adhesive or Vicryl sutures in pterygium surgery.
The study was performed in 81 patients (81 eyes) with primary nasal pterygium. Surgery in all patients consisted of the bare sclera technique combined with intraoperative administration of mitomycin C 0.02%. Patients were randomized to undergo conjunctival closure with a fibrin adhesive (Quixil) (n = 42) or Vicryl sutures (n = 39). Clinical assessment was performed on postoperative days 1, 3, 10, and 21 and thereafter at 3, 6, and 12 months. All patients completed a questionnaire at each follow-up visit grading pain, discomfort, and satisfaction with the procedure. The groups were compared for operative time, ocular signs and symptoms, overall satisfaction, and recurrence rate.
Average operative time was 16 min in the fibrin-glue group and 28 minutes in the Vicryl-suture group (p < 0.05). Significantly less pain and discomfort were noted in the subjects treated with glue than in controls (p < 0.05). Satisfaction was significantly higher in the study group (p < 0.04). There were no complications during follow-up period in the glue-treated patients; one patient in the suture group had a medically treatable corneal dellen. At the end of follow-up, recurrent pterygium developed in five (11.9%) eyes of the fibrin-glue group and in three (7.7%) eyes of the Vicryl-suture group (p < 0.05).
The use of fibrin glue in pterygium surgery significantly reduces operative time and patient pain compared with suturing. However, it may be associated with a higher recurrence rate.
比较翼状胬肉手术中使用纤维蛋白粘合剂或维克牢尼龙缝线进行结膜闭合的长期效果。
对81例（81眼）原发性鼻侧翼状胬肉患者进行了研究。所有患者的手术均采用裸巩膜技术并术中给予0.02%的丝裂霉素C。患者被随机分为两组，一组使用纤维蛋白粘合剂（Quixil）进行结膜闭合（n = 42），另一组使用维克牢尼龙缝线（n = 39）。在术后第1天、3天、10天和21天以及之后的3个月、6个月和12个月进行临床评估。所有患者在每次随访时都要完成一份问卷，对手术的疼痛、不适和满意度进行评分。比较两组的手术时间、眼部体征和症状、总体满意度以及复发率。
纤维蛋白胶组的平均手术时间为16分钟，维克牢尼龙缝线组为28分钟（p < 0.05）。使用胶水治疗的患者疼痛和不适明显少于对照组（p < 0.05）。研究组的满意度明显更高（p < 0.04）。胶水治疗的患者在随访期间没有并发症；缝线组有1例患者出现了可药物治疗的角膜小凹。随访结束时，纤维蛋白胶组有5只眼（11.9%）复发翼状胬肉，维克牢尼龙缝线组有3只眼（7.7%）复发（p < 0.05）。
与缝合相比，在翼状胬肉手术中使用纤维蛋白胶可显著缩短手术时间并减轻患者疼痛。然而，它可能与较高的复发率相关。
