NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
Department of Ophthalmology, University Hospitals Leicester, Infirmary Square, Leicester, LE1 5WW, UK.
Eye (Lond). 2021 Feb;35(2):639-643. doi: 10.1038/s41433-020-0935-8. Epub 2020 May 12.
To examine the safety and economic effect of using fibrin glue to reduce suturing of a donor patch graft and in conjunctival closure during aqueous shunt implantation.
Retrospective interventional case series of 150 patients from a single institution including historical controls from before the introduction of the change in technique. The surgery was performed by multiple glaucoma surgeons.
One hundred and fifty eyes of 150 patients were identified. The mean age was 54.3 ± 21.1 years. Previous surgery included: cataract extraction (34.7%), trabeculectomy (36%) and retinal surgery (15.3%). All operations were carried out by either a consultant (57%) or fellow (43%). A Baerveldt Glaucoma Implant (Advanced Medical Optics, Santa Ana, California, USA) was used in 149 eyes. Conventional surgery (CS) was performed for 91 eyes and fibrin glue (FG) was used for 59 eyes. Compared with conventional surgery (CS) in which the donor patch graft and conjunctiva were sutured, use of fibrin glue (FG) reduced the overall mean operating time by 11.2 min ± 6.4 min (P = 0.031), though much less for consultants (8.5 min ± 6.2 min) (P = 0.16) than fellows (32.9 min ± 7.2 min) (P < 0.0001). There were four cases of conjunctival dehiscence-three in the FG group and one in the CS group (P = 0.30). Only one patient required re-suturing in the FG group.
The use of fibrin glue is safe and effective during aqueous shunt implantation. We have shown that the mean operating time can be reduced significantly with the use of fibrin glue which has significant implications for resource utilisation.
研究在房水引流植入术中使用纤维蛋白胶减少供体贴片移植缝合和结膜闭合的安全性和经济效果。
对一家机构的 150 名患者进行回顾性干预性病例系列研究，包括技术引入前的历史对照。手术由多位青光眼外科医生进行。
共确定了 150 名患者的 150 只眼。平均年龄为 54.3±21.1 岁。既往手术包括白内障摘除术（34.7%）、小梁切除术（36%）和视网膜手术（15.3%）。所有手术均由顾问（57%）或研究员（43%）完成。149 只眼使用了 Baerveldt 青光眼植入物（美国加利福尼亚州圣安娜先进医疗光学公司）。常规手术（CS）用于 91 只眼，纤维蛋白胶（FG）用于 59 只眼。与常规手术（CS）相比，供体贴片移植和结膜缝合，使用纤维蛋白胶（FG）可将总手术时间平均减少 11.2±6.4 分钟（P=0.031），顾问的手术时间减少得更多（8.5±6.2 分钟）（P=0.16），而研究员的手术时间减少得更少（32.9±7.2 分钟）（P<0.0001）。有 4 例结膜裂开，3 例发生在 FG 组，1 例发生在 CS 组（P=0.30）。FG 组仅 1 例患者需要重新缝合。
在房水引流植入术中使用纤维蛋白胶是安全有效的。我们已经证明，使用纤维蛋白胶可以显著缩短平均手术时间，这对资源利用具有重要意义。
