Desai Arjun, Bhopalka Ankit Kumar, Tyagi Mudit, Sharma Sumant Vinayak, Takkar Brijesh
Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India.
IHOPE Research Centre, LVPEI, Hyderabad, India.
J Vitreoretin Dis. 2024 Apr 23;8(4):435-441. doi: 10.1177/24741264241247623. eCollection 2024 Jul-Aug.
To present the successful application of fibrin glue as a surgical adjunct in the management of complex rhegmatogenous retinal detachment (RRD). In this retrospective case series, fibrin glue was used as a surgical adjunct in 5 cases of complex RRD. In each case, standard pars plana vitrectomy and laser retinopexy were performed by the same surgeon. Fibrin glue was used intraoperatively as a tamponade to seal the breaks because the isolated use of conventional tamponade agents was not feasible given the variable nature of the complex RRDs, the anatomy of the eye, or an inability to maintain postoperative positioning. In 1 patient previously treated for a large corneoscleral tear, fibrin glue was used to seal a large iatrogenic retinal break caused by a fragmatome-related surge that led to a quadrantic RD. In 2 patients treated for combined RRD, fibrin glue was used with silicone oil to manage recurrent RRD with incompletely drained thick subretinal fluid and blood. In 2 other cases, fibrin glue was applied to manage RRD in congenital aniridia with advanced glaucoma and aphakia. In all cases, retinal attachment without serious adverse effects was attained over a follow-up ranging from 4 to 6 months. Fibrin glue is an effective, safe surgical adjunct in complex RRD. It can be used to transiently seal a retinal break when use of a conventional tamponade agent is not possible or not sufficient alone.
介绍纤维蛋白胶作为手术辅助材料在复杂孔源性视网膜脱离(RRD)治疗中的成功应用。在这个回顾性病例系列中,5例复杂RRD患者使用了纤维蛋白胶作为手术辅助材料。每例患者均由同一位外科医生进行标准的玻璃体切除术和平坦部视网膜光凝术。由于复杂RRD的多变性质、眼部解剖结构或无法维持术后体位,单独使用传统的填塞剂不可行,因此术中使用纤维蛋白胶作为填塞物来封闭裂孔。在1例曾因大的角膜巩膜裂伤接受治疗的患者中,纤维蛋白胶用于封闭由切割器相关手术导致的象限性视网膜脱离所引起的巨大医源性视网膜裂孔。在2例联合RRD患者的治疗中,纤维蛋白胶与硅油联合使用,以处理视网膜下液和血液引流不完全导致的复发性RRD。在另外2例病例中,纤维蛋白胶用于治疗伴有晚期青光眼和无晶状体眼的先天性无虹膜患者的RRD。在所有病例中,随访4至6个月期间均实现了视网膜复位,且无严重不良反应。纤维蛋白胶是复杂RRD治疗中一种有效、安全的手术辅助材料。当无法单独使用传统填塞剂或单独使用传统填塞剂不足时,它可用于临时封闭视网膜裂孔。