Conjunctivolimbal Autograft Using a Fibrin Adhesive in Pterygium Surgery
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Purpose: To evaluate the efficacy and safety of fibrin bioadhesive in conjunctivolimbal autograft surgery for primary pterygium. Methods: Thirty-six eyes in 34 patients were reviewed with nasal primary pterygium who were treated with pterygium excision with superior conjunctivolimbal transplantation with fibrin bioadhesive. Surgical durations were recorded and the patients were followed up on the first day after surgery and then at 1, 2, 4, 8 and 12 weeks postoperatively. The graft-recipient site attachments were examined and subjective symptoms of patients were recorded at every follow-up examinations. Results: The mean patient age was 57.9±10.1 (ranging from 33 to 83) years. The mean follow-up period was 22.05±5.78 weeks. The mean surgery time was 18.04±5.65 minutes. The subjective symptoms (pain, foreign body sensation, tearing and discomfort) disappeared in 23 of 36 eyes (64%) in one week after surgery, and all discomforts subsided within two weeks after surgery in all patients. The conjunctivolimbal autograft was correctly positioned and fixed in 34 of 36 eyes (94.4%) throughout the follow-up period. Graft dehiscence was seen in two eyes (5.6%), one eye was treated with remedial sutures, and the other eye showed a spontaneous healing without remedial sutures. Transient graft edema occurred in four eyes (11.2%) but subsided spontaneously within a month. There were no cases of pterygium regrowth or complications due to the fibrin bioadhesive. Conclusions: The use of fibrin bioadhesive in conjunctivolimbal autograft surgery in primary pterygium simplifies surgical techniques, shorten surgical duration, and produce less postoperative subjective symptoms . Therefore, the fibrin bioadhesive is a safe and effective tool to attach conjunctivolimbal autograft in primary pterygium surgery.
Abstract
Purpose: To evaluate the efficacy and safety of fibrin bioadhesive in conjunctivolimbal autograft surgery for primary pterygium. Methods: Thirty-six eyes in 34 patients were reviewed with nasal primary pterygium who were treated with pterygium excision with superior conjunctivolimbal transplantation with fibrin bioadhesive. Surgical durations were recorded and the patients were followed up on the first day after surgery and then at 1, 2, 4, 8 and 12 weeks postoperatively. The graft-recipient site attachments were examined and subjective symptoms of patients were recorded at every follow-up examinations. Results: The mean patient age was 57.9±10.1 (ranging from 33 to 83) years. The mean follow-up period was 22.05±5.78 weeks. The mean surgery time was 18.04±5.65 minutes. The subjective symptoms (pain, foreign body sensation, tearing and discomfort) disappeared in 23 of 36 eyes (64%) in one week after surgery, and all discomforts subsided within two weeks after surgery in all patients. The conjunctivolimbal autograft was correctly positioned and fixed in 34 of 36 eyes (94.4%) throughout the follow-up period. Graft dehiscence was seen in two eyes (5.6%), one eye was treated with remedial sutures, and the other eye showed a spontaneous healing without remedial sutures. Transient graft edema occurred in four eyes (11.2%) but subsided spontaneously within a month. There were no cases of pterygium regrowth or complications due to the fibrin bioadhesive. Conclusions: The use of fibrin bioadhesive in conjunctivolimbal autograft surgery in primary pterygium simplifies surgical techniques, shorten surgical duration, and produce less postoperative subjective symptoms . Therefore, the fibrin bioadhesive is a safe and effective tool to attach conjunctivolimbal autograft in primary pterygium surgery.
참고문헌 (31)
- Lee SH, "Immune reactions in pterygium", J Korean Ophthalmol Soc, 28, pp.933~7 (1987)
- Allan BDS, "Pinguecula and pterygia", Surv Ophthalmol, 32, pp.41~9 (1988)
- Amano S, "Comparative study of intraoperative mitomycin C and beta irradiation in pterygium surgery", Br J Ophthalmol, 84, pp.618~21 (2000)
- Talu H, "Excimer laser phototherapeutic keratectomy for recurrent pterygium", J Cataract Refract Surg, 24, pp.1326~32 (1998)
- Na KS, "A clinical observation on the argon laser effect of the pterygium", J Korean Ophthalmol Soc, 37, pp.1120~5 (1996)
- Joselson GA, "Incidence of pterygium recurrence in patients treated with Thio-tepa", Am J Ophthalmol, 81, pp.891~5 (1966)
- Panda A, "Randomized trial of intaoperative mitomycin C in surgery for pterygium", Am J Ophthalmol, 125, pp.59~63 (1998)
- Rubinfeld RS, "Serious complications of topical mitomycin-C after pterygium surgery", Ophthalmology, 99, pp.1647~54 (1992)
- Ma DH, "Aminotic membrane graft for primary pterygium: comparision with conjunctival autograft and topical mitomycin C treatment", Br J Ophthalmol, 84, pp.973~8 (2000)
- Sanchez-Thorin JC, "Meta-analysis on the recurrence rates after bare sclera resection with and without mitomycin C use and conjunctival autograft placement in surgery for primary pterygium", Br J Ophthalmol, 82, pp.661~5 (1998)
- Tan DT, "Effect of pterygium morphology on pterygium recurrence in a contolled trial comparing conjunctival autografting with bare sclera excision", Arch Ophthalmol, 115, pp.1235~40 (1997)
- Lagoutte FM, "A fibrin sealant for perforated and preperforated corneal ulcers", Br J Ophthalmol, 73, pp.757~61 (1989)
- Mandel MA, "Closure of blepharoplasty incisions with autologous fibrin glue", Arch Ophthalmol, 108, pp.842~4 (1990)
- Kajiwara K, "Repair of a leaking bleb with fibrin glue", Am J Ophthalmol, 109, pp.599~601 (1990)
- Kaufman HE, "Human fibrin tissue adhesive for sutureless lamellar keratoplasty and scleral patch adhesion: a pilot study", Ophthalmology, 110, pp.2168~72 (2003)
- Cohen RA, "Fixation of conjunctival autografts with an organic tissue adhesive", Arch Ophthalmol, 111, pp.1167~8 (1993)
- Koranyi G, "Cut and paste: a no suture, small incision approach to pterygium surgery", Br J Ophthalmol, 88, pp.911~4 (2004)
- Harvey SU, "Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision", Ophthal- mology, 112, pp.667~71 (2005)
- Kim JC, "Clinical use of human amniotic membrane for ocular surface diseases", Advances in Corneal Research, pp.117~34 (1997)
- Sridhar MS, "Surgically induced necrotizing scleritis after pterygium excision and conjunctival autograft", Cornea, 21, pp.305~7 (2002)
- Ti SE, "Analysis of variation in success rates in conjunctival autografting for primary and recurrent pterygium", Br J Ophthalmol, 84, pp.385~9 (2000)
- Kim YS, "Limbal-conjunctival autograft transplantation for the treatment of primary pterygium", J Korean Ophthalmol Soc, 40, pp.1804~10 (1999)
- Guler M, "Limbal-conjunctival autograft transplantation in cases with recurrent pterygium", Acta Ophthalmologica, 72, pp.721~6 (1994)
- Polute P, "Long-term results of autologous conjunctival-limbus transplantation in pterygium", Klin Monatsbl Augenheilkd, 213, pp.9~14 (1998)
- Ahn DG, "The clinical results of limbal conjunctival transplantation with intraoperative mitomycin C application for recurrent pterygium", J Korean Ophthalmol Soc, 40, pp.2443~9 (1999)
- 박정민, "재발성군날개 및 거짓군날개 환자에서 양막과 각막윤부 동시이식술의 임상적 효과", 대한안과학회지, 44(7), pp.1504~1511 (2003), 대한안과학회
- Oh TH, "The effect of conjunctival autograft for recurrent pteygium", J Korean Ophthalmol Soc, 35, pp.1335~9 (1994)
- Van Herendael BJ, "Microanatomy of the human amniotic membrane: a light microscopic, transmission, and scanning microscopic study", Am J Obstet Gynecol, 131, pp.872~80 (1978)
- Terranova VP, "Chemotaxis of human gingival epithelial cells to laminin: a mechanism for epithelial cell apical migration", J Periodontol, 57, pp.311~7 (1986)
- Na BK, "Analysis of human amniotic membrane components as proteinase inhibitors for development of therapeutic agent for recalcitrant keratitis", Tropho Res, 13, pp.453~66 (1999)
- Kim MJ, "Treatment of pterygium with amniotic membrane transplantation", J Korean Ophthalmol Soc, 39, pp.59~64 (1998)