Department of Ophthalmology, National University Hospital, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Ann Med. 2021 Dec;53(1):448-455. doi: 10.1080/07853890.2021.1901304.
To compare the recurrence rate and outcomes of double-headed pterygia using fibrin glue versus suture closure of conjunctival autograft.
All patients with double-headed pterygia who underwent pterygia excision with conjunctival autograft from January 2012 to January 2019 in the National University Hospital of Singapore were included. Patients were divided into 2 groups depending on whether fibrin glue or sutures were used to secure the conjunctival autograft in place. All patients had a minimum of 6 months follow-up.
A total (26 patients) of 22 eyes had fibrin glue, while eight eyes underwent suture closure of their conjunctival autograft. Fibrin glue group had 4.5% recurrence rate, while suture group had 37.5% recurrence rate ( = .021). There is statistically significant improvement for overall visual acuity ( = .009) and cylinder ( = .002). There is also statistically significant improvement for visual acuity in the glue group ( = .026), but not in the suture group. Fibrin glue group had a shorter operation duration time compared to suture group ( < .001).There were no cases of graft dislocation, contraction or limbal stem cell deficiency.
Low recurrence rates and good postoperative visual outcomes can be achieved with the split conjunctival autograft technique. Our study suggests that fibrin glue has an additional benefit over the use of sutures in the management of these complex cases.
比较使用纤维蛋白胶与缝线闭合结膜移植物治疗双头翼状胬肉的复发率和结局。
纳入 2012 年 1 月至 2019 年 1 月期间在新加坡国立大学医院接受翼状胬肉切除术联合结膜自体移植的所有双头翼状胬肉患者。根据是否使用纤维蛋白胶或缝线固定结膜移植物，将患者分为两组。所有患者均随访至少 6 个月。
共有 26 例（22 只眼）患者使用纤维蛋白胶，8 例患者采用缝线闭合结膜移植物。纤维蛋白胶组的复发率为 4.5%，缝线组的复发率为 37.5%（ = .021）。总体视力（ = .009）和散光（ = .002）均有统计学显著改善。纤维蛋白胶组的视力也有统计学显著改善（ = .026），但缝线组无改善。纤维蛋白胶组的手术时间短于缝线组（ < .001）。无移植物脱位、收缩或角膜缘干细胞缺乏的病例。
使用分体结膜自体移植技术可以获得较低的复发率和良好的术后视力结局。我们的研究表明，在处理这些复杂病例时，纤维蛋白胶比缝线具有额外的优势。
