Department of Ophthalmology, the First Affiliated Hospital of Jinan University, Guangzhou, China.
Ophthalmology. 2011 Jun;118(6):1049-54. doi: 10.1016/j.ophtha.2010.10.033. Epub 2011 Feb 3.
To evaluate the safety and clinical efficacy of fibrin glue in pterygium surgery with conjunctival autografting.
The use of fibrin glue has been introduced in the treatment of pterygium. However, its role versus traditional suturing is still a matter of debate. We performed a meta-analysis to compare the safety and clinical efficacy of fibrin glue with suture for conjunctival autograft attachment in pterygium surgery.
A total of 342 participants with 366 eyes in 7 studies were analyzed.
We searched Medline, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for relevant randomized controlled trials (RCTs).
The methodological quality of all the included trials was assessed with the Jadad score. The meta-analysis was performed with the fixed-effects model for complication rate and recurrence rate, and random-effects model for operating time.
Fibrin glue was associated with a significantly decreased operating time (weighted mean difference -17.61 minutes, 95% confidence interval [CI], -26.03 to -9.18, P<0.0001) and was more effective in reducing the recurrence rate (Peto odds ratio [OR] 0.33, 95% CI, 0.15-0.71, P = 0.004) compared with suture. There were no significant differences in the complication rate (Peto OR 1.82, 95% CI, 0.63-5.27, P = 0.27) between the 2 groups.
Our meta-analysis supports the superiority of fibrin glue to suture in pterygium surgery with conjunctival autografting in that the use of fibrin glue can significantly reduce the recurrence rate without increasing the risk of complications. Ophthalmologists should consider the use of fibrin glue in pterygium surgery.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估纤维蛋白胶在自体结膜移植翼状胬肉手术中的安全性和临床疗效。
纤维蛋白胶已被应用于翼状胬肉的治疗。然而，其与传统缝合的作用仍存在争议。我们进行了一项荟萃分析，以比较纤维蛋白胶与缝线在翼状胬肉手术中固定自体结膜移植物的安全性和临床疗效。
共有 7 项研究的 342 名参与者（366 只眼）纳入分析。
我们检索了 Medline、EMBASE、Web of Science、Cochrane 中央对照试验注册库和 Google Scholar，以寻找相关的随机对照试验（RCT）。
所有纳入试验的方法学质量均采用 Jadad 评分进行评估。并发症发生率和复发率采用固定效应模型进行荟萃分析，手术时间采用随机效应模型进行荟萃分析。
纤维蛋白胶可显著缩短手术时间（加权均数差值-17.61 分钟，95%置信区间[CI]，-26.03 至-9.18，P<0.0001），并降低复发率（Peto 比值比[OR]0.33，95%CI，0.15-0.71，P=0.004），与缝线相比。两组间并发症发生率差异无统计学意义（Peto OR 1.82，95%CI，0.63-5.27，P=0.27）。
我们的荟萃分析支持纤维蛋白胶在自体结膜移植翼状胬肉手术中的优势，即纤维蛋白胶的使用可以显著降低复发率，而不会增加并发症的风险。眼科医生在翼状胬肉手术中应考虑使用纤维蛋白胶。
作者在本文讨论的任何材料中均没有自有或商业利益。
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