Comparison of fibrin glue and sutureless autologous conjunctival flap fixation in the treatment of pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the outcome in terms of patients comfort, graft stability, graft inflammation, recurrence and other postoperative complications between the two sizes of conjunctivolimbal autograft used in fibrin glue and suture less glue free methods of conjunctivolimbal autograft fixation for primary pterygium surgery.<p>METHODS: This was a prospective interventional comparative study conducted on 80 patients(80 eyes)with pterygium from December 2014 to August 2016. The study group was randomly selected and divided into two groups, <i>i.e.</i> people underwent fibrin glue was group 1, and those underwent suture less glue free methods of autograft fixation was group 2. For each group equal numbers of subjects were enrolled and further each group was divided into two more groups(groups A and B in group 1, groups C and D in group 2)by random selection. Group A(size of autograft same as bare sclera)and group B(size 1 mm larger than bare sclera)received fibrin glue technique; and group C(size of autograft same as bare sclera)and group D(size 1 mm larger than bare sclera)received suture less glue free technique of conjunctival autograft fixation. Each patient underwent pterygium excision with size of conjunctival autograft used as per the respective group. Follow up visits were scheduled at 1d, 1wk, 6wk, 6mo and 1y postoperatively.<p>RESULTS: Mean age of the patients in group 1(Fibrin glue group)was 43.525 years old and in group 2(suture less glue free group)was 42.2 years old. Females were 60 and males were 20. All the 37 patients had pterygium in RE. Average surgical time was similar in all the four groups. Postoperative parameters like patient comfort, graft retraction, graft inflammation and graft edema were similar in all the four groups during every postoperative follow-up visits except for subconjunctival haemorrhage which was significantly more in fibrin glue group until first postoperative week(<i>P</i><0.0001). Grade 4 graft retraction/displacement was observed in only three patients from group 2. At 1wk postoperative, graft cyst was observed in two patients(one in group A and one in group D). Recurrence was observed in two patients(in group D)at 6mo follow-up.<p>CONCLUSION: Both methods are safe and effective for graft adhesion with less postoperative discomfort and complications. Compared to fibrin glue method, suture less and glue free method is very economical and outcome in this method is comparable to fibrin glue group. Since this procedure is cost effective and also have all the advantages of fibrin glue, suture less glue free method can be considered as very effective method in treating patients.

The Application of Sclera Fixing Surgery in Suture Less Posterior Chamber Intraocular Lens / 昆明医科大学学报

Objective To evaluate the clinical efficacy of sclera fixing surgery in suture less posterior chamber intraocular lens (IOL). Method From March 2016 to February 2018, 60 patients undergoing IOL implantation in the Yuxi People's Hospital were selected as the study objects. They were randomly divided into thd study group (n=30) and the control group (n=30).The control group was given suture and fixation of ciliary sulcus in intraocular lens. The study group was treated with sclero fixing surgery in suture less posterior chamber intraocular lens, and we analyzed the visual acuity, intraocular lens stability, and occurrence of adverse reactions in both groups.Result The visual acuity of the study group was significantly better than that of the control group (P＜0.05). The stability of the intraocular lens was better in the study group than in the control group (P＜0.05). The incidence of adverse reactions in the study group was significantly higher than that of the control group (6.67％) (P＜0.05). Conclusions The sclera fixation surgery in suture less posterior chamber intraocular lens is a safe and effective treatment method for posterior chamber IOL without lens implantation with full capsular support, which has less trauma and fewer complications than sclera suture fixation of posterior chamber intraocular lens.It can effectively improve the vision of patients, significantly reduce the incidence of adverse reactions, and is beneficial to to patient's prevention, and it is worth for promoting.

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.

The sutureless circumcision – an alternative to the standard technique.

Introduction: Circumcision is a commonly performed surgery. Surgeons have become increasingly interested in the use of adhesive bonds. Recent advances have been made in the use of tissue glu in the circumcision. In this study, we used 2-octul cyanoacrylate for closing circumcision wounds and we have reported our experience. Material & Methods: this was a prospective non-prospective preliminary clinical study involving 30 patients where 2-octyl cyanoacrylate was used as a tissue adhesive for wound closure after formal formal circumcision at of our department. Result: In this study, there is significant less pain. There is 10% (3 cases) of complication are observed. The wound cosmesis score on 90th post-operative day is optimal except in one patient of woud separation. Conclusion: The comparison with criterions of time taken for skin closure.

Use of topical skin adhesive (2-octyl cyanoacrylate) following circumcision surgery.

Introduction: circumcision is a commonly performed surgery. Surgeons have become increasingly interested in the use of adhesive bonds. Recent advances have been made in the use of tissue glue in the circumcision. In this study, we used 2-octyl cyanoacrylate for closing circumcision wounds and we have reported our experience. Material & Methods: this was a prospective non-comparative preliminary clinical study involving 30 patients where 2-octyl cyanoacrylate was used as a tissue adhesive for wound closure after formal circumcision at surgery department, Smt S.C.L. Municipal General Hospital from May 2008 to Nov 2010. Result: in this study, the mean time taken for skin closure by 2-octyl cyanoacrylate is much faster in last year of study. There is significant less pain. There is 10% (3 cases) of complications are observed. The wound cosmesis score on 90th post-operative day is optimal except in one patient of wound separation. Conclusion: the comparison with criterions of time taken foe skin closure, the post-operative pain, the cosmetic appearance of adhesive glue proves that 2-octyl cyanoacrylate skin closure is significantly better than the traditional skin suturing skin closure.

Effect of Incision Length and Incision Site on Surgically Induced Astigmatism in Sutureless Cataract Surgery

The refractive effects of incision parameters on surgically induced astigmatism in sutureless cataract surgery were studied retrospectively by automatic keratometeric evaluation. 215 eyes undergoing phacoemulsification and posterior chamber intraocular lens implantation were divided into five groups according to the incision length, direction and location : group 1 (14 eyes), 3.5mm superior scleral incision : group 2 937 eyes), 3.2mm temporal clear corneal incision : group 3 (24 eyes), 3.2mm temporal scleral incison : group 4 (24 eyes), 5.5mm superior scleral incision : group 5 (116 eyes), 5.5mm temporal scleral incision. All eyes were examined by keratometry preoperatively as well as at 1 days, at 1 and 2 weeks and at 1 and 2 months after surgery. Cravys vector analysis was performed to calculate the surgically induced astigmatism and keratometric readings were converted to polar values to estimate the mean postoperative keratometric astigmatism. After two postoperative months, mean induced atigmatism was -0.37+/-0.36D in Group 1, 0.27+/-0.44D in Group 2, 0+/-0.33D in Group 3, -0.74+/-0.46D in Group 4 and 0.22+/-0.63D in Group 5. There fore we constructed our own nomogram for managing astigmatism at cataract surgery.