Fibrin Glue-Assisted Conjunctival Autografting in Pterygium Surgery

組織凝膠於自體結膜移植眼翼手術之應用

黃奕勛(Yi-Hsun Huang) ； 曾順輝(Sung-Huei Tseng) ； 陳盈廷(Ying-Ting Chen)

《中華民國眼科醫學會雜誌》 49卷4期 (2010/12) Pp. 552-561

https://doi.org/10.30048/ACTASOS.201012.0006

摘要

目的：評估在自體結膜移植眼翼手術中使用組織凝膠之可行性
設計一：前瞻非比較性病例系列。
方法：我們將20位眼翼病患區分為兩組，第一組為初次接受眼翼手術之13名患者；第二組為復發性眼翼病患，共7名。第二組病患於術中額外接受0.02% mitomycin C浸潤。所有眼翼病患皆使用組織凝膠黏著自體結膜。評估項目包括手術時間、術後病人的不適感、及復發率。
結果：病患平均年齡為62.2±11.6歲（36-80歲間），術後追蹤時間介於7到20個月（平均士標準差，12.9±3.5個月）。兩組病患平均手術時間分別為16.7±4.0分鐘及24.5±3.7分鐘，術後病患無明顯不適感。兩組病患術後第一天疼痛指數分別為0.9±0.5分及1.3±0.8分，術後一個禮拜疼痛指數則分別為0.0±0.0分和0.2±0.4分。追蹤期間內，僅有一例眼翼復發，整體復發率為5.0%。
結論：眼翼手術時使用組織凝膠協助自體結膜移植，不僅可縮短手術時間，降低病患術後的不適感，且可減少復發率的發生，但仍須長期追蹤以獲得更精確的結果。

並列摘要

Objective: To evaluate the feasibility of applying fibrin glue (FG) in pterygium excision surgery with conjunctival autografts (CAG).
Design: Prospective non-comparative case series
Methods: Twenty patients with primary or recurrent pterygium. Patients were divided into two groups: group 1 consisted of 13 eyes (13 patients) with primary pterygium; group 2 had 7 eyes (7 patients) with recurrent pterygium. All patients in group 2 received additional intraoperative 0.02% mitomycin C on the pterygium-removed bare sclera for 3 minutes prior to CAG. FG was applied to replace sutures for graft fixation in all cases. Main outcome measures include levels of patient's discomfort, operation time, and pterygium recurrence rate.
Results: Mean age of overall patients was 62.2±11.6 years old (range, 36-80 years old). Postoperative follow-up period ranges from 7 to 20 months (mean±SD, 12.9±3.5 months). Mean operation time was 16.7±4.0 minutes and 24.5±3.7 minutes in group 1 and 2, respectively. Minimal post-op discomfort was noted in both group 1 and group 2 with no significant difference. The postoperative pain score was 0.9±0.5 and 1.3±0.8 on Day 1, 0.0±0.0 and 0.2±0.4 at one week in group 1 and 2, respectively. By the end of study, recurrence of pterygium was found only in a single case in group 1 and none in group 2, with an overall recurrence rate of 5.0%.
Conclusion: FG-assisted CAG in pterygium surgery significantly shortened operation time, alleviated postoperative discomfort and reduced disease recurrence. However, a comparative study and longer follow-up are needed to validate its effect in reducing pterygium recurrence.

並列關鍵字

fibrin glue ； pterygium surgery ； conjunctival autografts