ABSTRACT
@#AIM: To compare the efficacy and characteristic of human fibrin sealant in the surgery of pterygium. <p>METHODS: A prospective randomized controlled study was conducted. A total of 148 eyes of 148 patients with pterygium were involved in the study from June 2016 to September 2017. All patients were divided into two groups receiving 10-0 vicryl sutures or human fibrin sealant respectively. Patients were seen on postoperative 1, 3d, 1wk, 1, 3, and 6mo after surgery. The duration of surgery, level of patient discomfort, pterygium recurrence, and complications were retrospectively analyzed between two groups. <p>RESULTS: The duration of surgery in observer group was 15.23±2.26min and 28.22±2.70min in control group, the difference was statistically significant(<i>t</i>=-31.75, <i>P</i><0.01). One week later, the level of patient discomfort at 1, 3 and 7d after surgery were 0.62±0.69, 0.34±0.50, 0.16±0.37 in observation group, and the level of patient discomfort were 1.15±0.92, 0.54±0.60, 0.18±0.38 in control group, and the difference were statistically significant in observer group and control group(<i>P</i><0.01); comparison between any two means in either group was significantly different(<i>P</i><0.01). There were significant difference between the two groups on postoperative 1, 3d after surgery(<i>t</i>=-3.94, -2.22; <i>P</i><0.05), and there was not significant difference between the two groups on postoperative 7d after surgery(<i>t</i>=-0.22, <i>P</i>>0.05). Two eyes(2.7%)were recurrent on postoperative 6mo after surgery in observation group and 4 of 74 eyes(5.4%)in control group, demonstrated no significant differences(<i>χ</i><sup>2</sup>=24.2, <i>P</i>>0.05). Five of 74 eyes(6.8%)were with complications in observation group and 6 of 74 eyes(8.1%)in control group, demonstrated no significant differences(<i>χ</i><sup>2</sup>=16.32, <i>P</i>>0.05). <p>CONCLUSION: The duration of surgery, patient discomfort level were reduced markedly, as less flap dislocation and postoperative reaction with human fibrin sealant compared with 10-0 vicryl sutures. A good result can be obtained by using the human fibrin sealant in the surgery of pterygium.
ABSTRACT
PURPOSE: To report two cases of sutureless corneal surgery performed with human fibrin sealant: lamellar keratoplasty and revision of traumatic LASIK flap dislocation. METHODS: In one case, lamellar keratoplasty was performed because of corneal opacity in the anterior stroma, which occurred after herpes simplex keratitis. Free flaps were made in donor and recipient corneas using an Automated Corneal Shaper(TM) (ACS(TM)). After human fibrin sealant was applied to the surface of the recipient's stromal bed, the donor's corneal flap was attached to the bed. The other patient evaluated had partial dislocation of the LASIK flap following trauma. The corneal epithelium covered the lifted and wrinkled corneal flap. The epithelium was removed after applying 20% alcohol. Then, the flap was repositioned and fixed using human fibrin sealant. RESULTS: At postoperative 3 months, clarity and integrity were maintained without serious complications. Visual acuity was improved in both cases. However, an additional procedure was needed in the case of LASIK flap revision because of epithelial ingrowth. CONCLUSIONS: Human fibrin sealant is an effective tool for corneal surgery and is advantageous because it does not require sutures. However, further studies that involve a large number of patients and a longer follow-up period are required to validate its universal use.