Dal Pizzol Melissa Manfroi, Roggia Murilo Felix, Kwitko Sérgio, Marinho Diane Ruschel, Rymer Samuel
Setor de Córnea e Doenças Externas, Serviço de Oftalmologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
Arq Bras Oftalmol. 2009 May-Jun;72(3):308-12. doi: 10.1590/s0004-27492009000300006.
To evaluate the use of fibrin glue and its complications in different ophthalmic surgeries.
A retrospective and non-comparative case series study. 161 eyes were evaluated. The mean age was 51.8 years. Fibrin glue (Beriplast--Aventis Behring, Germany) was used in all patients for tissue adherence or incisional closure.
Main preoperatives diseases were pterygium (76 patients), superior limbic keratoconjunctivitis (4 patients), limbal tumor (4 patients), conjunctivochalasis (21 patients), bullous keratopathy (31 patients), limbal stem cell deficiency (7 patients), alkali injury (6 patients), Stevens-Johnson syndrome (2 patients), cataract (5 patients) and glaucoma (5 patients). Complications occurred in 28 patients (17.4%). Detachment of the fixed tissue and granulomatous foreign body reaction were the main complications. Detachment occurred in 10 cases (5.6%) (7 in amniotic membrane transplantation in bullous keratopathy, 2 in autologous conjunctival grafting for pterygium surgery, 1 in autologous limbal transplantation in a Stevens-Johnson syndrome). Granulomatous foreign body reaction was described in 9 patients (5.6%) (5 in amniotic membrane transplantation due to acute alkali injury, 1 in autologous limbal graft due to chronic burn injury, and 3 in autologous conjunctival transplant due to pterygium surgery). All the complications described occurred in the first week after surgery.
Despite the limitations related to the retrospective and non-comparative setting, this study suggests that the use of fibrin glue seems to be safe and effective for tissue fixation or incisional closure presenting low rates of complications in ocular surface and anterior segment surgeries.
评估纤维蛋白胶在不同眼科手术中的应用及其并发症。
一项回顾性非对照病例系列研究。共评估了161只眼。平均年龄为51.8岁。所有患者均使用纤维蛋白胶（德国贝林公司的百克瑞）进行组织黏附或切口闭合。
主要术前疾病有翼状胬肉（76例）、上睑缘角结膜炎（4例）、角膜缘肿瘤（4例）、结膜松弛症（21例）、大泡性角膜病变（31例）、角膜缘干细胞缺乏（7例）、碱烧伤（6例）、史蒂文斯-约翰逊综合征（2例）、白内障（5例）和青光眼（5例）。28例患者（17.4%）出现并发症。固定组织脱离和肉芽肿性异物反应是主要并发症。10例（5.6%）发生脱离（大泡性角膜病变羊膜移植7例、翼状胬肉手术自体结膜移植2例、史蒂文斯-约翰逊综合征自体角膜缘移植1例）。9例患者（5.6%）出现肉芽肿性异物反应（急性碱烧伤羊膜移植5例、慢性烧伤自体角膜缘移植1例、翼状胬肉手术自体结膜移植3例）。所有所述并发症均发生在术后第一周。
尽管本研究存在回顾性和非对照性的局限性，但提示纤维蛋白胶用于组织固定或切口闭合似乎是安全有效的，在眼表和眼前节手术中并发症发生率较低。
