Yüksel Bora, Unsal Sultan Kaya, Onat Sevgi
Department of Ophthalmology, Izmir Bozyaka Teaching and Research Hospital, Turkey.
Int J Ophthalmol. 2010;3(4):316-20. doi: 10.3980/j.issn.2222-3959.2010.04.09. Epub 2010 Dec 18.
To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft.
A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium. Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision. In 29 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive (Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures. The Mann-Whitney U test was used for statistical analysis. Postoperative patient discomfort (pain, stinging, watering) and biomicroscopic findings (hyperemia, edema) were graded. Patients were followed up at least for six months.
Subconjunctival hemorrhage occured under the graft in one patient in group 1. In seven cases of group 2, sutures were removed at the 15(th) day because of granulomatous tissue reaction. Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in one case of group 1, and 2 cases of group 2. Average surgery cost was higher (P<0.05) and surgery time was shorter (P<0.05) in fibrin group.
Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.
比较纤维蛋白胶与缝合技术在自体角膜缘移植翼状胬肉手术中的有效性和安全性。
对58例原发性鼻侧翼状胬肉患者的58只眼进行前瞻性随机临床试验。取自颞上角膜缘的自体结膜移植片在翼状胬肉切除后覆盖巩膜。29只眼中，移植片用纤维蛋白组织黏合剂（贝瑞普利P）固定于巩膜，另29只眼用8-0的维珍妮丝线缝合。采用曼-惠特尼U检验进行统计学分析。对术后患者的不适（疼痛、刺痛、流泪）和生物显微镜检查结果（充血、水肿）进行分级。患者至少随访6个月。
第1组1例患者移植片下发生结膜下出血。第2组7例患者因肉芽肿组织反应在第15天拆除缝线。第1组患者症状明显较轻，生物显微镜检查结果较好。第1组1例、第2组2例出现翼状胬肉复发。纤维蛋白组平均手术费用较高（P<0.05），手术时间较短（P<0.05）。
在翼状胬肉手术中使用纤维蛋白胶固定移植片可显著减轻术后疼痛并明显缩短手术时间。
