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在小梁切除术中使用纤维蛋白粘合剂进行结膜闭合。

Use of a fibrin adhesive for conjunctival closure in trabeculectomy.

机构信息

Ophthalmology Department, Clinico San Carlos Hospital, Ophthalmology Department of Medicine School, Complutense University of Madrid, Health Investigative Institute of Clinico San Carlos Hospital (IdISSC), Madrid, Spain.

出版信息

Acta Ophthalmol. 2013 Aug;91(5):425-8. doi: 10.1111/j.1755-3768.2012.02436.x. Epub 2012 May 3.

Abstract

PURPOSE

To assess the safety and efficacy of a fibrin tissue adhesive (Tissucol Duo(®) ) used to close the conjunctiva in trabeculectomy.

METHODS

A nonrandomized prospective study including 57 patients with chronic simple glaucoma who underwent trabeculectomy surgery. All the trabeculectomies were conducted by the same surgeon using the same surgical technique with the exception that conjunctival closure was achieved by either running Nylon 10/0 suture (n = 29) or using the fibrin glue (n = 28). Preoperative and postoperative data were obtained on intraocular pressure (IOP), number of hypotensive medications used, self-reported discomfort and complications arising during and after surgery.

RESULTS

No differences were detected between the two patient groups regarding the intraocular pressure reduction achieved during follow-up. In the first 2 weeks of follow-up, reported discomfort assessed using a visual analogue scale was significantly lower in the Tissucol Duo(®) group. Two patients in the Tissucol Duo(®) group suffered conjunctival dehiscence and suturing was required at 24 hours postsurgery. Remaining complications were similar in the two groups.

CONCLUSION

The use of Tissucol Duo(®) seems to be a safe and efficient option for conjunctival closure in trabeculectomy that simplifies the surgical procedure and reduces patient discomfort in the immediate postoperative period.

摘要

目的

评估纤维蛋白组织粘合剂(Tissucol Duo(®))用于小梁切除术结膜闭合的安全性和有效性。

方法

这是一项非随机前瞻性研究,纳入了 57 例慢性单纯性青光眼患者,均接受小梁切除术。所有的小梁切除术均由同一位外科医生采用相同的手术技术进行,不同之处在于结膜闭合采用连续尼龙 10/0 缝线(n=29)或纤维蛋白胶(n=28)。收集术前和术后的数据,包括眼压(IOP)、使用的降眼压药物数量、自我报告的不适以及手术期间和之后出现的并发症。

结果

在随访期间,两组患者的眼压降低情况无差异。在随访的前 2 周,使用视觉模拟评分评估的 Tissucol Duo(®)组报告的不适明显更低。Tissucol Duo(®)组有 2 例患者发生结膜裂开,术后 24 小时需要缝合。两组的其余并发症相似。

结论

Tissucol Duo(®) 用于小梁切除术结膜闭合似乎是一种安全有效的选择,它简化了手术过程,并在术后即刻减轻了患者的不适。

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