Repeated use of fibrin sealants kept at room temperature in conjunctival autografting: An animal study

Purpose: In this study, our aim was to investigate if fibrin adhesives used in conjunctival wound surgery with autologous conjunctival grafts could be used repeatedly at different times after surgical opening. Methods: 40 New Zealand rabbits were used in the study. These animals were divided into four groups, each consisting of 10 rabbits, and hence 20 eyes. In the first group (control group), Tisseel fibrin sealant was used on the day the eye was first opened surgically; in the second group, it was used on the seventh day; on the third group, it was used on the 14th day; and in the fourth group, it was used 28 days after surgical opening. The graft from the inferior bulbar conjunctiva was attached using Tisseel fibrin glue to the superior scleral bed at the location where the superior bulbar conjunctiva was excised in the same eye. Results: No microbial growth was detected in the cultures of the samples tested. There were two partial graft loss in group 2 and there was one partial graft loss in each group of the other groups, and further total graft loss was present in one rabbit in group 3. None of the rabbits had any complications like granuloma, Corneal dellen or infection. Conclusion: Based on these results, fibrin sealants can be used repeatedly by storing them at room temperature. Repeated use of fibrin adhesives will reduce the cost of ophthalmologic surgeries and non?ophthalmologic surgeries

Sutureless and glue-free limbal-conjunctival autograft in primary and recurrent pterygium: A pilot study

Purpose: To evaluate and analyze the outcomes of sutureless and glue?free limbal?conjunctival autografting in cases of primary as well as recurrent pterygium. Methods: This prospective interventional study was carried out between February 2019 and February 2020 at a tertiary care hospital in North India. A total of 70 patients with pterygium underwent sutureless and glue?free limbal?conjunctival autograft. The patients were divided into two groups: group 1 patients with primary pterygium (n = 45), group 2 patients with recurrent pterygium (n = 25). The patients were followed up till 12 months postoperatively. Results: The mean age of the patients in group 1 and group 2 was 37.04 ± 8.69 years and 32.52 ± 6.49 years, respectively (P = 0.04). Postoperatively, no recurrence was recorded in group 1. Recurrence was noticed in two patients (8%) of group 2. The BCVA changed from 78.73 ± 9.86 letters to 80.15 ± 7.29 letters (P = 0.45) and from 79.6 ± 6.44 letters to 79.8 ± 5.86 letters (P = 0.45) in group 1 and group 2, respectively. Graft edema was found in seven (15.55%) cases of group 1 and four (16%) cases of group 2. Graft retraction was found in two (4.44%) cases of group 1 and three (12%) cases of group 2. Conclusion: Sutureless and a glue?free limbal?conjunctival autograft is a safe and effective treatment option for primary as well as recurrent pterygium.

A Comparative Study To Evaluate The Outcome Of Sutures Versus Fibrin Glue In Conjunctival Autograft Technique For Primary Pterygium Excision

Background:Pterygium is degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue and is characterized by formation of a triangular fold of conjunctiva encroaching on the cornea leading to visual impairment, restriction of ocular motility, chronic in?ammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Now, Fibrin glue is being tried since few years to secure grafts in place of the sutures. The objective of this study was to compare duration of surgery, immediate postoperative complications which includes an in?ammation, subconjunctival haemorrhage, patient comfort, graft stability between the uses of ?brin glue versus sutures. Methods:A total of 40 patients having primary pterygium were included in the study. 20 patients were underwent pterygium excision surgery and conjunctival autografting using absorbable vicryl 8-0 suture and 20 patients underwent pterygium excision surgery and conjunctival autografting using ?brin glue. These 2 groups were compared in terms of duration of the surgery, in?ammation, degree of postoperative discomfort, subconjunctival haemorrhage and graft stability at postoperative day 1. Results:The mean surgery time in ?brin glue group was 15 minutes and mean surgery time in suture group was 28 minutes (p=0.000). Fibrin glue group had signi?cantly lesser in?ammation (p=0.001) as well as postoperative discomfort (p=0.000) compared to suture group at postoperative day 1. There was no signi?cant difference found in the degree of subconjunctival haemorrhage between the ?brin glue versus sutures groups (p=0.887 and p=0.797 at day 1). The grafts secured with ?brin glue were as stable as those secured with the sutures (p=0.745, 0.644 at day 1). Conclusion:The ?brin glue group in conjunctival autografting had signi?cantly less surgery time, which also produces signi?cantly less postoperative discomfort as well as in?ammation with grafts being as stable as those secured with sutures. Fibrin glue can be used regularly if patients can be pooled together and operated on, by making it cost effective procedure

Recurrence Rate in Primary Pterygium Managed by Surgical Excision of Pterygium with Application of Mitomycin-C over Bare Sclera and Free Conjunctival Autografting

Background: To study recurrence rate in 50 cases of primary pterygium managed by surgical excision of pterygium along with application of mitomycin-C 0.02% over bare sclera for 2 minutes and ipsilateral free conjunctival autografting. Methods: This prospective observational study was carried out on 50 patients of primary pterygium operated between 25.05.2016—10.08.2016. Pterygium excision was done, 0.02% mitomycin-C was applied over bare sclera for 2 minutes and ipsilateral free conjunctival autografting was done using sutures. Patients were followed up for a mean period of 13.27 months for recurrence.  Results: 55 eyes of 50 patients were operated by above technique by a single surgeon1. Three (3) patients were lost in follow up. In an average follow-up time of 13.27 months, recurrence was found in only 1 case (1.92%). No serious side effects were observed in this study. Conclusions: Primary    Pterygium     managed     by     excision  of  pterygium followed by intraoperative mitomycin-C application and conjunctival autografting is an easy, reproducible and cost effective method which helps in reducing recurrence with minimal complications.

Suture Less and Glue Free Limbal Conjunctival Autografting following Pterygium Excision.

A prospective interventional self-control study to analyse the profile and outcome of suture less and glue free limbal conjunctival autograft for the management of primary pterygium was carried out in 80 eyes with primary nasal pterygium requiring surgical excision. Pterygium excision with limbal conjunctival autografting without using glue or sutures was performed in all the eyes followed by bandaging for 24 hours. The patients were followed up post operatively after 24 hrs., on 3rd day, after 1, 3, 6 weeks and at 3 months. They were examined for visual acuity, hemorrhage, wound gape, graft retraction, graft edema, recurrence or any other complication among the study population. The mean age of the patients was 40.78 years (range 19-80), 56.25% of which were females. Graft retraction occurred in 3 eyes (3.75%) and recurrence was seen in 1 eye (1.25%). Hemorrhage was seen in 26 (32.5%) eyes at 24 hours, which persisted in only 06(7.5%) eyes at 3 weeks and resolved completely in 100% of eyes at 6 weeks. Edema was also noted in 4 (5%) eyes, persisted only in 1(1.25%) eye at 3rd day and resolved completely by 1 week. At 6 weeks postoperatively, three (3.75%) eyes showed gain in best corrected visual acuity by one line and one (1.25%) eye by three lines on snellen's drum. No other complication was noted. Suture less and glue free limbal conjunctival autografting following pterygium excision is an effective and safe option for the management of primary pterygium.

Comparison of different concentration mitomycin C in the treatment of recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To compare the clinical efficacy of treatment on recurrent pterygium using different concentration mitomycin C ( MMC) in the pterygium excision operation combined with the corneal limbal stem cell autografting ( CLSCA) .METHODS: Sixty patients ( 65 eyes ) with recurrent pterygium were randomly divided into three groups. All cases were accepted CLSCA, 21 patients (22 eyes) were given 0. 15g/L MMC during operation, 20 patients ( 22 eyes) were given 0. 25g/L MMC during operation, 19 patients ( 21 eyes ) were given 0. 4g/L MMC during operation. The patients were followed up for 6mo to 2a.RESULTS:The recurrent rates of the three groups were 9%, 5%, 5% respectively. There was no statistically significant differences (P>0. 05). The complication rates of the three groups were 5%, 36%, 33% respectively. There were statistically significant differences (P<0. 05). CONCLUSlON: The treatment to the recurrent pterygium using low concentration MMC has the similar recurrence rates, but the complication rate was lower, it is an ideal operation method, and it is worth popularization and application.

Astigmatic changes following pterygium removal: Comparison of 5 different methods.

Aims: To investigate the effect of surgery type on the postoperative astigmatism in pterygium surgery. Settings and Design: Retrospective comparative clinical trial. Materials and Methods: Data of 240 eyes that underwent pterygium excision were investigated. Following removal of the pterygium, patients underwent 5 different types of surgeries: Conjunctival autograft with sutures (CAG-s) or fibrin glue (CAG-g), conjunctival rotational flap (CRF), or amniotic membrane transplantation with either suture (AMT-s) or with glue (AMT-g). The preoperative and postoperative keratometric measurements, evaluated using an automated keratorefractometer, were noted. Statistical Analysis: The overall changes in BCVA and astigmatic degree were evaluated using Wilcoxon signed rank test. The difference in astigmatic values between groups was calculated using one way analysis of variance (ANOVA). Results: The most commonly performed procedure was CAG-s (N = 115), followed by CAG-g (N = 53), CRF (N = 47), AMT-s (N = 15), and AMT-g (N = 10). Following surgery, astigmatic values decreased from 3.47 ± 2.50 D to 1.29 ± 1.07 D (P < 0.001, paired t test). The changes in astigmatism was significantly related to the preoperative size of the pterygium (ρ = 3.464, P = 0.005). The postoperative astigmatism correlated with preoperative astigmatism (ρ = 0.351, P < 0.001, Spearman correlation analysis). The changes in astigmatic values was not related to the method of surgery (P = 0.055, ANOVA). Conclusion: Pterygium results in high corneal astigmatism, which decreases to an acceptable level following excision. According to our study, the type of grafting as CAG, CRF or AMT or the use of suture or glue to fixate the graft does not have a significant effect on the change in astigmatism degree.

Artrodesis de radio distal con autoinjerto masivo de cresta iliaca en tumor de células gigantes: reporte de un caso / Arthrodesis of the distal radio with massive iliac crest bone autograft in a giant cell tumor: a case report

El tumor de células gigantes se presenta en cerca del 5% de todos los tumores óseos benignos en adultos; es un tumor que a pesar de su naturaleza benigna, la mayoría de las veces tiene un comportamiento agresivo, lo cual causa severa incapacidad y limitación funcional. Existen técnicas descritas para manejo de este tipo de tumor en el radio distal, mediante resección, aplicación de aloinjerto, curetaje intralesional y aumentación con cemento. En este artículo reportamos el caso de una mujer con un tumor de células gigantes del radio distal tratado mediante resección ampliada de la lesión y reconstrucción con un autoinjerto masivo de cresta iliaca. Se describe la técnica y se reporta el resultado funcional.

Giant cell tumors appear in approximately 5% of all benign bone tumors in adults; despite its benignity, it is usually aggressive, leading to severe functional disability and limitations. Techniques have been described for the management of this type of tumor in the radio distal using surgical resection, application of allograft, intralesional curettage and cement augmentation. In this article we report on the case of a female patient with a giant cell tumor in the radio distal treated with wide resection of the lesion and reconstruction with massive iliac crest bone autograft. The technique is described and a report is provided on the functional result.

Primary pterygium surgery –comparsion of limbal conjunctival autografting versus intra- operative mitomycin-C.

Pterygium is a fibro vascular encroachment of the conjunctival tissue on to the cornea, causing variable degree of ocular morbidity. Various surgical modalities have been developing to decrease the recurrence. The idea of study is to compare the relative efficacy of two well known procedures i.e. conjunctival autografting and intra-operative Mitomycin –C (0.02%) with reference to recurrence and complication rate.

Changes of androgen and estrogen receptors in male pattern baldness after hair autografting / 中华医学美学美容杂志

Objective To explore the role of androgen receptor (AR) and estrogen receptor (ER) on male pattern baldness (MPB). Methods The contents of AR and ER in donor and recipient sites of scalps after hair autografting were determinated in 13 cases of MPB. Fluorescent steroid hormone conjugate technique was employed in this study. Results There was no statistical difference in the contents of AR and ER between donor site and grafted scalps in recipient site. Conclusion After the donor tissues are transplanted to the recipient site (the former baldness site), there is no change in contents of AR and ER. The abnormal change of the content of AR and ER in scalp plays an important role in MPB development.