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翼状胬肉手术中免缝合、免胶的结膜自体移植:病例系列。

Sutureless and glue-free conjunctival autograft in pterygium surgery: a case series.

机构信息

Department of Ophthalmology, Addenbrookes Hospital, Cambridge, UK.

出版信息

Eye (Lond). 2010 Sep;24(9):1474-7. doi: 10.1038/eye.2010.75. Epub 2010 Jun 4.

Abstract

AIMS

Foreign materials used in ocular surface surgery may lead to local complications such as discomfort, scarring, or infection. Plasma-derived products such as fibrin glue may produce possible hypersensitivity reactions whereas the risk of viral transmission remains. We describe a simple method of achieving conjunctival autograft adherence during pterygium surgery avoiding potential complications associated with the use of fibrin glue or sutures.

METHODS

After pterygium excision and fashioning of the autologous conjunctival graft, the recipient bed is encouraged to achieve natural haemostasis and relative dessication before graft placement. Excessive haemorrhage in the graft bed is tamponaded. Graft adherence and positioning is examined 20 min after surgery.

RESULTS

A total of 15 eyes of 12 patients (mean (SD) age 73.7 (11.2) years), 8 females underwent SGF autologous conjunctival graft post-pterygium excision. Mean graft area was 24(1.5)mm(2). Mean follow-up time was 9.2 (2.2) months. Cosmesis was excellent in all cases and visual acuity improved in one patient. There were no intra- or post-operative complications requiring further treatment.

CONCLUSION

This simple technique for pterygium surgery may prevent potential adverse reactions encountered with the use of foreign materials and in this small series provided safe and comparable results to current methods.

摘要

目的

眼表手术中使用的外来材料可能导致局部并发症,如不适、瘢痕形成或感染。纤维蛋白胶等血浆衍生产品可能会产生潜在的过敏反应,而病毒传播的风险仍然存在。我们描述了一种在翼状胬肉手术中实现结膜自体移植物粘附的简单方法,避免了使用纤维蛋白胶或缝线可能带来的并发症。

方法

翼状胬肉切除和自体结膜移植物成形后,在放置移植物之前,鼓励受床自然止血并相对干燥。用止血海绵填塞移植物床的过度出血。术后 20 分钟检查移植物的粘附和定位。

结果

共有 12 例患者(平均年龄 73.7(11.2)岁,8 名女性)的 15 只眼在翼状胬肉切除后接受了 SGF 自体结膜移植物。平均移植物面积为 24(1.5)mm(2)。平均随访时间为 9.2(2.2)个月。所有病例的美容效果均极佳,1 例视力改善。无术中或术后并发症需要进一步治疗。

结论

这种用于翼状胬肉手术的简单技术可以预防使用外来材料时遇到的潜在不良反应,并且在本小系列中,与当前方法相比,提供了安全且可比的结果。

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