Sandra Sekelj, Zeljka Janjetovic, Zeljka Vukovic Arar, Kristian Samardzic, Ivana Aric
Department of Ophthalmology, General Hospital Dr. J. Bencevic, KS Djalskog 2, 35000, Slavonski Brod, Croatia,
Int Ophthalmol. 2014 Feb;34(1):75-9. doi: 10.1007/s10792-013-9799-2. Epub 2013 Jun 4.
To evaluate the influence of pterygium morphology on the efficacy and safety of fibrin glue in pterygium surgery with conjunctival autografting. A prospective case series. During a period of 15 months, 45 patients (51 eyes) were recruited from the General Hospital for pterygium surgery. Seven eyes (13.73 %) were operated on for a recurrent pterygium. Autologous conjunctiva was harvested from the superior bulbar conjunctiva and fixed with fibrin glue. The pterygia were preoperatively divided into atrophic/grade 1 (n = 18; 35.29 %), intermediate/grade 2 (n = 22; 43.14 %) or fleshy/grade 3 (n = 11; 21.57 %) according to clinical morphology. Patients were evaluated for intraoperative and postoperative complications and recurrence rates. The success rate was defined by no pterygium recurrences. Patients with 2-year follow-ups were included in this study. Fifty-one patients (21 females/30 males) with a mean age of 60-65 years (range 24-87 years) took part in the study. All patients completed the study. No intraoperative complications were noted. Postsurgical complications included graft edema (n = 4; 7.8 %), graft hyperemia (n = 2; 3.8 %), and graft dislocation (n = 3; 5.9 %); these complications were transient. One graft unfastened completely (2 %) and five pterygium recurrences occurred (n = 5; 9.8 %). The overall success rate was 90 % after 2 years. In grade I group there were no recurrences, in grade 2 group there were two recurrences, and in grade 3 group there were three recurrences. There were significantly more recurrences in grade 3 group than in grade 2 group. There were more recurrences in both groups than in group 1 (60 vs 40 vs 0 % of all recurrences, p ≤ 0.05). The use of fibrin glue is a safe, easy and effective technique for attaching the conjunctival autograft in pterygium surgery. The morphology of pterygium influences recurrence rates, without significance for intraoperative and postoperative complications.
评估翼状胬肉形态对翼状胬肉切除联合自体结膜移植术中使用纤维蛋白胶的疗效及安全性的影响。一项前瞻性病例系列研究。在15个月的时间里，从综合医院招募了45例患者（51只眼）进行翼状胬肉手术。其中7只眼（13.73%）为复发性翼状胬肉。自体结膜取自上方球结膜并用纤维蛋白胶固定。术前根据临床形态将翼状胬肉分为萎缩性/1级（n = 18；35.29%）、中间型/2级（n = 22；43.14%）或肥厚型/3级（n = 11；21.57%）。对患者的术中及术后并发症和复发率进行评估。成功率定义为无翼状胬肉复发。本研究纳入了随访2年的患者。51例患者（21例女性/30例男性）参与了研究，平均年龄60 - 65岁（范围24 - 87岁）。所有患者均完成了研究。术中未发现并发症。术后并发症包括移植片水肿（n = 4；7.8%）、移植片充血（n = 2；3.8%）和移植片脱位（n = 3；5.9%）；这些并发症均为一过性。1片移植片完全松动（2%），发生了5例翼状胬肉复发（n = 5；9.8%）。2年后总体成功率为90%。1级组无复发，2级组有2例复发，3级组有3例复发。3级组的复发明显多于2级组。两组的复发均多于1级组（分别占所有复发的60%、40%和0%，p≤0.05）。在翼状胬肉手术中，使用纤维蛋白胶固定自体结膜移植片是一种安全、简便且有效的技术。翼状胬肉的形态影响复发率，但对术中及术后并发症无显著影响。
