Parmar Gautam Singh, Ghodke Bhushan, Meena Ashok Kumar
Department of Cornea and Refractive Services, Sadguru Seva Sang Trust, Chitrakoot, Madhya Pradesh, India.
J Ophthalmic Vis Res. 2020 Feb 2;15(1):32-37. doi: 10.18502/jovr.v15i1.5938. eCollection 2020 Jan-Mar.
To evaluate the efficacy of releasable single suture (RS) for conjunctival autograft (CAG) and to compare it with sutureless gluefree (SG) technique in pterygium surgery.
We conducted a retrospective comparative study on patients with primary pterygium who underwent CAG. In 150 patients, CAG was additionally secured by a single 10-0 nylon releasable suture (RS) which was released on the first postoperative day. In 47 patients, no suture was applied, and CAG was allowed to stick to the scleral bed by autologous fibrin only (SG group). The duration of surgery and size of CAG (in mm ) was noted in both groups. All patients completed one year of follow-up. Factors that were studied included graft stability, patient comfort, complications, and recurrence.
The mean age of patients in RS and SG groups was 39.6 11.8 and 47.3 13.8 years, respectively. The mean duration of surgery was 4.84 1.34 min in RS group and 4.90 1.42 min in SG group ( = 0.001). The size of CAG used in both groups was comparable with more stability in RS group postoperatively. Graft retraction rate in RS group was 5.3% (1 mm retraction in CAG more than 36 mm ) with no event of graft loss. The graft loss occurred in 6.3% of eyes in SG group. The recurrence rate in RS group was 4%, while in SG group it was 6.3% ( = 0.4).
RS, by augmenting the autologous blood mechanism, may offer an easy to learn option for pterygium surgery with good stability even in large sized CAGs.
评估可松解单缝线（RS）用于结膜自体移植（CAG）的疗效，并在翼状胬肉手术中将其与无缝线免胶水（SG）技术进行比较。
我们对接受CAG的原发性翼状胬肉患者进行了一项回顾性对照研究。150例患者中，CAG通过一根10-0尼龙可松解缝线（RS）额外固定，该缝线在术后第一天松解。47例患者未应用缝线，CAG仅通过自体纤维蛋白附着于巩膜床（SG组）。记录两组的手术时间和CAG大小（以毫米为单位）。所有患者均完成了一年的随访。研究的因素包括移植物稳定性、患者舒适度、并发症和复发情况。
RS组和SG组患者的平均年龄分别为39.6±11.8岁和47.3±13.8岁。RS组的平均手术时间为4.84±1.34分钟，SG组为4.90±1.42分钟（P = 0.001）。两组使用的CAG大小相当，术后RS组的稳定性更高。RS组的移植物回缩率为5.3%（CAG回缩超过36平方毫米1毫米），无移植物丢失事件。SG组6.3%的眼发生了移植物丢失。RS组的复发率为4%，而SG组为6.3%（P = 0.4）。
RS通过增强自体血液机制，可能为翼状胬肉手术提供一种易于掌握的选择，即使在大尺寸CAG中也具有良好的稳定性。
