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观察翼状胬肉切除术后影响纤维血管再生的因素,并比较结膜自体移植缝线与纤维蛋白胶的疗效和并发症。

Observing the factors affecting fibrovascular regrowth after pterygium excision and comparing the efficacy and complications of conjunctival autograft with sutures versus fibrin glue.

机构信息

Department of Ophthalmology, Moti Lal Nehru Medical College, Prayagraj, India.

出版信息

Rom J Ophthalmol. 2023 Jul-Sep;67(3):289-297. doi: 10.22336/rjo.2023.47.

DOI:10.22336/rjo.2023.47
PMID:37876514
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10591428/
Abstract

To observe the factors affecting fibrovascular regrowth after pterygium excision and to compare the efficacy and complications of conjunctival autograft with sutures versus fibrin glue. 65 consenting patients with primary pterygium attending the outpatient department having appropriate indications for surgery were enrolled. Data was collected using personal interviews. Routine pre-operative ophthalmic examination was done, including visual acuity assessment, slit lamp examination, and fundus evaluation. Pterygium excision surgery was done on all patients using either Fibrin Glue or 10-0 nylon sutures. Patients were followed up at weeks 1, 4, 12, and 24 and any complications were duly noted. The fibrin glue group showed milder postoperative discomfort, symptoms, and signs compared to the suture group. Pyogenic granuloma (3.12%), corkscrew vessels (6.25%), and subconjunctival hemorrhage (24.99%) were more common in the fibrin glue group. FVG not crossing the limbus was observed in 6.25% of glue cases and 9.09% of suture cases, more in fleshy and large pterygia, while age and gender did not alter the incidence of FVG. No recurrences were observed in any group. The incidence of fibrovascular regrowth (FVG) was not affected by age, gender, smoking, and surgical technique, but was positively correlated with length and grade of pterygium. The complication rate between the two groups was not found to be statistically significant. Despite causing severe postoperative discomfort and requiring prolonged surgical time, suture-assisted pterygium surgery is a cost-effective method still being used with long-term outcomes similar to fibrin glue.

摘要

观察翼状胬肉切除术后纤维血管再生的影响因素,并比较结膜自体移植缝线与纤维蛋白胶的疗效和并发症。65 名符合条件的原发性翼状胬肉门诊患者同意参加手术,有适当的手术指征。通过个人访谈收集数据。所有患者均行常规术前眼科检查,包括视力评估、裂隙灯检查和眼底评估。所有患者均行翼状胬肉切除术,采用纤维蛋白胶或 10-0 尼龙缝线。患者在第 1、4、12 和 24 周进行随访,并记录所有并发症。纤维蛋白胶组的术后不适、症状和体征较缝线组轻。化脓性肉芽肿(3.12%)、螺旋状血管(6.25%)和结膜下出血(24.99%)在纤维蛋白胶组更为常见。纤维血管性再生(FVG)未越过角膜缘在胶病例中占 6.25%,在缝线病例中占 9.09%,在肉质和大翼状胬肉中更为常见,而年龄和性别并不改变 FVG 的发生率。任何一组均未观察到复发。纤维血管再生(FVG)的发生率不受年龄、性别、吸烟和手术技术的影响,但与翼状胬肉的长度和分级呈正相关。两组之间的并发症发生率无统计学差异。尽管缝线辅助翼状胬肉手术会引起严重的术后不适和需要延长手术时间,但它仍然是一种具有成本效益的方法,长期结果与纤维蛋白胶相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/3d2efe09672d/RomJOphthalmol-67-289-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/c2000ef1e794/RomJOphthalmol-67-289-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/234440a09bc9/RomJOphthalmol-67-289-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/3d2efe09672d/RomJOphthalmol-67-289-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/c2000ef1e794/RomJOphthalmol-67-289-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/234440a09bc9/RomJOphthalmol-67-289-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c8b/10591428/3d2efe09672d/RomJOphthalmol-67-289-g003.jpg

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本文引用的文献

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Geographical prevalence and risk factors for pterygium: a systematic review and meta-analysis.翼状胬肉的地理流行率和危险因素:系统评价和荟萃分析。
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A comparative study of the effect of fibrin glue versus sutures on clinical outcome in patients undergoing pterygium excision and conjunctival autografts.纤维蛋白胶与缝线对翼状胬肉切除联合自体结膜移植患者临床结局影响的比较研究
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