Kim Hyun Ho, Mun Hong Jae, Park Young Jeung, Lee Kyoo Won, Shin Jae Pil
Department of Ophthalmology, Cheil Eye Hospital, Daegu, Korea.
Korean J Ophthalmol. 2008 Sep;22(3):147-54. doi: 10.3341/kjo.2008.22.3.147.
To evaluate the efficacy and safety of fibrin bioadhesive in conjunctivolimbal autograft surgery for primary pterygium.
Thirty-six eyes in 34 patients were reviewed with nasal primary pterygium who were treated with pterygium excision with superior conjunctivolimbal transplantation with fibrin bioadhesive. Surgical durations were recorded and the patients were followed up on the first day after surgery and then at 1, 2, 4, 8 and 12 weeks postoperatively. The graft-recipient site attachments were examined and subjective symptoms of patients were recorded at every follow-up examinations.
The mean patient age was 57.9+/-10.1 (ranging from 33 to 83) years. The mean follow-up period was 22.05+/-5.78 weeks. The mean surgery time was 18.04+/-5.65 minutes. The subjective symptoms (pain, foreign body sensation, tearing and discomfort) disappeared in 23 of 36 eyes (64%) in one week after surgery, and all discomforts subsided within two weeks after surgery in all patients. The conjunctivolimbal autograft was correctly positioned and fixed in 34 of 36 eyes (94.4%) throughout the follow-up period. Graft dehiscence was seen in two eyes (5.6%), one eye was treated with remedial sutures, and the other eye showed a spontaneous healing without remedial sutures. Transient graft edema occurred in four eyes (11.2%) but subsided spontaneously within a month. There were no cases of pterygium regrowth or complications due to the fibrin bioadhesive.
The use of fibrin bioadhesive in conjunctivolimbal autograft surgery in primary pterygium simplifies surgical techniques, shorten surgical duration, and produce less postoperative subjective symptoms . Therefore, the fibrin bioadhesive is a safe and effective tool to attach conjunctivolimbal autograft in primary pterygium surgery.
评估纤维蛋白生物黏附剂在原发性翼状胬肉结膜角膜缘自体移植手术中的疗效和安全性。
回顾性分析34例患者的36只鼻侧原发性翼状胬肉眼，这些患者接受了翼状胬肉切除联合上方结膜角膜缘移植术并使用纤维蛋白生物黏附剂。记录手术时长，并在术后第1天、术后1周、2周、4周、8周和12周对患者进行随访。每次随访时检查植片与受体部位的附着情况，并记录患者的主观症状。
患者平均年龄为57.9±10.1岁（范围33至83岁）。平均随访时间为22.05±5.78周。平均手术时间为18.04±5.65分钟。36只眼中的23只（64%）在术后1周主观症状（疼痛、异物感、流泪和不适）消失，所有患者在术后2周内所有不适均消退。在整个随访期间，36只眼中的34只（94.4%）结膜角膜缘自体移植片位置正确并固定良好。2只眼（5.6%）出现植片裂开，1只眼经补救缝合治疗，另1只眼未行补救缝合自行愈合。4只眼（11.2%）出现短暂的植片水肿，但在1个月内自行消退。未发生因纤维蛋白生物黏附剂导致的翼状胬肉复发或并发症病例。
在原发性翼状胬肉结膜角膜缘自体移植手术中使用纤维蛋白生物黏附剂可简化手术技术、缩短手术时长并减少术后主观症状。因此，纤维蛋白生物黏附剂是原发性翼状胬肉手术中固定结膜角膜缘自体移植片的一种安全有效的工具。
