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翼状胬肉切除术后一种新型移植选择:用于结膜成形术的富血小板纤维蛋白

A novel graft option after pterygium excision: platelet-rich fibrin for conjunctivoplasty.

作者信息

Cakmak H B, Dereli Can G, Can M E, Cagil N

机构信息

Department of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Department of Ophthalmology, Yildirim Beyazit University Faculty of Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.

出版信息

Eye (Lond). 2017 Nov;31(11):1606-1612. doi: 10.1038/eye.2017.109. Epub 2017 Jun 16.

Abstract

PurposeTo compare the surgical results, complications, and recurrence rates of primary pterygium excision with conjunctival autografts (CA) vs platelet-rich fibrin (PRF) grafts.Patients and methodsA total of 35 eyes of 35 patients with primary pterygium were included in the study. The patients underwent excision of pterygium followed by closure of the bare sclera by CA (group 1, n=20) vs PRF grafts (group 2, n=15). The PRF was generated from the patients' own whole-blood sample by centrifugation and pressing. The surgery times, intra/postoperative complications, recurrence rates of pterygium, and changes in visual acuity (VA) were evaluated and compared within groups.ResultsThe mean follow-up period was 14.3±6.5 months (6-24 months). The mean preoperative and postoperative VAs were same (20/25) (P=0.204). The mean surgery time was shorter in group 2 (22.1±1.9 min) compared to group 1 (33.8±7.8 min) (P=0.001). The recurrence was observed only in one (6.6%) case of group 2, while none of the cases showed recurrence in group 1. Graft loss was observed in 2 (10%) cases in group 1, and 1 (6.6%) case in group 2. No other intra/postoperative complications such as tear in the graft, excessive bleeding, scleral necrosis, graft necrosis, pannus formation, or symblepharon occurred in both groups.ConclusionsThis preliminary study showed encouraging results of the application of PRF for conjuntivoplasty after pterygium excision. The use of PRF in pterygium surgery is a simple, easily applicable, and a promising method with low rates of recurrence and complications.

摘要

目的

比较原发性翼状胬肉切除联合自体结膜移植(CA)与富血小板纤维蛋白(PRF)移植的手术效果、并发症及复发率。

患者与方法

本研究共纳入35例原发性翼状胬肉患者的35只眼。患者接受翼状胬肉切除,随后分别采用CA(第1组,n = 20)和PRF移植(第2组,n = 15)封闭裸露的巩膜。PRF由患者自身全血样本经离心和挤压产生。评估并比较两组的手术时间、术中/术后并发症、翼状胬肉复发率及视力(VA)变化。

结果

平均随访期为14.3±6.5个月(6 - 24个月)。术前和术后平均视力相同(20/25)(P = 0.204)。第2组的平均手术时间(22.1±1.9分钟)比第1组(33.8±7.8分钟)短(P = 0.001)。仅在第2组的1例(6.6%)患者中观察到复发,而第1组无一例复发。第1组有2例(10%)出现移植片丢失,第2组有1例(6.6%)。两组均未发生其他术中/术后并发症,如移植片撕裂、出血过多、巩膜坏死、移植片坏死、血管翳形成或睑球粘连。

结论

这项初步研究显示了PRF在翼状胬肉切除术后结膜成形术中应用的令人鼓舞的结果。PRF用于翼状胬肉手术是一种简单、易于应用且有前景的方法,复发率和并发症发生率低。

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