Department of Vitreoretinal Surgery, Ankara Ulucanlar Eye Research Hospital, Ankara, Turkey.
Eye (Lond). 2009 Jun;23(6):1382-7. doi: 10.1038/eye.2008.252. Epub 2008 Sep 5.
To describe the use of tissue glue to close scleral and conjunctival wounds, and to compare the clinical outcomes using tissue glue and vicryl suture for closing these areas in conventional 20-gauge (G) vitrectomy.
Thirty eyes of 30 patients were included in this study. The indications for vitreoretinal surgery were diabetic vitreous haemorrhage with severe vitreoretinal traction in 10 eyes, retinal detachment and proliferative vitreoretinopathy in 14 eyes, and vitreous opacity in 6 eyes. Tissue glue (Tisseel, Baxter AG Industries, Vienna, Austria) was used to attach scleral and conjunctival wounds in 15 eyes and vicryl sutures in 15 eyes. The patients were allotted into two subgroups as tissue glue group (TG) and vicryl suture group (VG). The sclerotomy sites were evaluated with ultrasound biomicroscopy (UBM) postoperatively in TG. Follow-up period was 2 months. The groups were statistically compared for ocular signs and symptoms by Mann-Whitney U-test.
No scleral wound leakage and conjunctival reattachment were observed at the end of the surgical procedure and during the follow-up period. No adverse effects were seen in TG. Abnormal fibrous ingrowth was not detected at the sclerotomy sites by means of UBM in TG. Patient comfort was significantly higher in TG than VG (P<0.05).
Tissue glue has no adverse effects on ocular tissue and can be used as a substitute for suture materials, and the use of tissue glue decreases patient symptoms during the postoperative period after 20-G vitrectomy. Tissue glue can enable to perform sutureless surgery in the conventional 20-G vitrectomy.
描述使用组织胶封闭巩膜和结膜伤口,并比较在常规 20G 玻璃体切除术中使用组织胶和薇乔缝线封闭这些部位的临床结果。
本研究纳入了 30 例(30 只眼)患者。玻璃体视网膜手术的适应证为:10 只眼为糖尿病玻璃体积血伴严重玻璃体视网膜牵引,14 只眼为视网膜脱离伴增生性玻璃体视网膜病变,6 只眼为玻璃体混浊。15 只眼使用组织胶(Tisseel,Baxter AG Industries,Vienna,Austria),15 只眼使用薇乔缝线(vicryl sutures)来固定巩膜和结膜伤口。患者被分为组织胶组(TG)和薇乔缝线组(VG)。术后在 TG 中通过超声生物显微镜(UBM)评估巩膜穿刺部位。随访时间为 2 个月。通过 Mann-Whitney U 检验对两组的眼部体征和症状进行统计学比较。
手术结束时和随访期间均未观察到巩膜伤口渗漏和结膜再附着。TG 中未观察到不良反应。TG 中,UBM 未检测到巩膜穿刺部位有异常纤维性内生长。TG 中患者舒适度明显高于 VG(P<0.05)。
组织胶对眼组织无不良影响,可替代缝线材料,在 20G 玻璃体切除术后,组织胶的使用可减轻患者的术后症状。组织胶可使常规 20G 玻璃体切除术中实现无缝线手术。