Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos, Porto Alegre, RS, 90035-903, Brazil.
Int Ophthalmol. 2023 Jul;43(7):2371-2381. doi: 10.1007/s10792-023-02635-z. Epub 2023 Jan 18.
To describe and compare the autologous fibrin glue and traditional sutures for conjunctival graft attachment in patients undergoing primary pterygium excision surgery.
A randomized clinical trial included patients who underwent pterygium surgery with conjunctival autologous graft (CAG). Using randomization, a single-trained surgeon performed graft fixation with autologous glue or sutures. The glue was prepared immediately before the surgery, using the patient's blood components. After centrifugation, the plasma was collected and enhanced with calcium gluconate. Postoperative assessments were performed on Days 1, 7, 21, 30 and 180. The study evaluated postoperative edema and pain and complications. The mean surgical time was compared. Recurrence of the pterygium was assessed 6 months postoperatively.
The study evaluated 61 eyes. Thirty-three eyes underwent pterygium surgery using the glue technique, and 28 underwent the traditional suture technique. Fifty-one patients (83.60%) had successful graft adhered to at the end of follow-up. Ten patients (10/33) lost their graft in the glue group, and only 69.70% maintained graft presence in the fourth week versus 100% of the patients in the suture group (p = 0.001). Pain scores were lower in the glue group, and clinical edema was significantly higher. There was no significant difference in graft retraction or the presence of granuloma, necrosis or postoperative infection.
Autologous fibrin glue is an affordable option for CAG fixation in particular contexts where commercial fibrin glue is unavailable, and it could offer advantages compared to sutures. A higher graft loss rate was observed and might be related to topical anesthesia, and improvements to the technique are needed.
gov Identifier: NCT04151017. https://clinicaltrials.gov/ct2/show/NCT04151017?term=20170467&draw=1&rank=1 .
描述并比较原发性翼状胬肉切除术患者中使用自体纤维蛋白胶和传统缝线固定结膜移植物的效果。
一项随机临床试验纳入了接受翼状胬肉手术和自体结膜移植物（CAG）的患者。由一位受过专门训练的外科医生使用随机分组的方式，采用自体胶或缝线固定移植物。胶在手术前立即制备，使用患者的血液成分。离心后收集血浆并加入葡萄糖酸钙增强。术后第 1、7、21、30 和 180 天进行评估。研究评估了术后水肿、疼痛和并发症。比较了平均手术时间。术后 6 个月评估翼状胬肉的复发情况。
该研究评估了 61 只眼。33 只眼采用胶技术进行翼状胬肉手术，28 只眼采用传统缝线技术。51 例患者（83.60%）在随访结束时成功固定移植物。胶组中有 10 例（10/33）患者移植物丢失，第四周时仅 69.70%的患者保持移植物存在，而缝线组的患者均保持移植物存在（p = 0.001）。胶组疼痛评分较低，临床水肿明显较高。移植物回缩、肉芽肿、坏死或术后感染的发生率无显著差异。
在某些情况下，如无法获得商业纤维蛋白胶时，自体纤维蛋白胶是固定 CAG 的一种经济实惠的选择，与缝线相比可能具有优势。观察到较高的移植物丢失率，这可能与局部麻醉有关，需要改进技术。
gov 标识符：NCT04151017。https://clinicaltrials.gov/ct2/show/NCT04151017?term=20170467&draw=1&rank=1 。
