Alamdari Daryoush Hamidi, Sedaghat Mohamad-Reza, Alizadeh Reza, Zarei-Ghanavati Siamak, Naseri Hashem, Sharifi Fatemeh
Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Cornea Department and Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Int Ophthalmol. 2018 Jun;38(3):1219-1224. doi: 10.1007/s10792-017-0585-4. Epub 2017 Jun 17.
To compare the safety, operating time, postoperative ocular signs, symptoms, overall patient satisfaction, complications rate and recurrence rate of autologous fibrin glue (AFG) and nylon suturing (NS) for attaching conjunctival autografts in pterygium surgery.
A prospective, randomized, interventional study was performed among 120 patients (120 eyes) with primary pterygium. Superior conjunctival autograft was harvested and transferred on to bare sclera after pterygium excision. For attaching the autograft, AFG (n = 60 eyes) and NS (n = 60 eyes) were used. The patients were followed up for 12 months. The groups were compared for the safety, operative time, postoperative ocular signs, symptoms, overall patient satisfaction, recurrence and complications rate.
All conjunctival autografts in both groups were successfully attached. The average operating time for the AFG group was significantly shorter (P < 0.001). Postoperative symptoms were fewer for the AFG group than the suture group. After 12 months of follow-up, no recurrence was reported for the AFG group, but 8.3% of patients experienced recurrence in the NS group.
Our study demonstrated the superiority of AFG to NS in saving operating time and elimination of recurrence without any complications in pterygium surgery. AFG can obviate the need for suturing and increases the viability of tissue flaps. Additional studies are necessary to determine the long-term effects considering factors such as primary or recurrent status of pterygium, age and sex of patient, dose and duration of treatment for mitomycin C.
比较自体纤维蛋白胶（AFG）和尼龙缝合（NS）在翼状胬肉手术中用于结膜自体移植片附着的安全性、手术时间、术后眼部体征、症状、患者总体满意度、并发症发生率和复发率。
对120例（120眼）原发性翼状胬肉患者进行前瞻性、随机、干预性研究。切除翼状胬肉后，取上方结膜自体移植片并转移至裸露的巩膜上。对于附着自体移植片，分别使用AFG（60眼）和NS（60眼）。对患者进行12个月的随访。比较两组的安全性、手术时间、术后眼部体征、症状、患者总体满意度、复发率和并发症发生率。
两组所有结膜自体移植片均成功附着。AFG组的平均手术时间明显更短（P<0.001）。AFG组术后症状比缝合组少。随访12个月后，AFG组未报告复发，但NS组有8.3%的患者出现复发。
我们的研究表明，在翼状胬肉手术中，AFG在节省手术时间、消除复发且无任何并发症方面优于NS。AFG可避免缝合的需要并提高组织瓣的存活率。考虑到翼状胬肉的原发或复发状态、患者年龄和性别、丝裂霉素C的治疗剂量和持续时间等因素，有必要进行更多研究以确定其长期效果。
