Autologous fibrin glue versus sutures for conjunctival autograft in primary pterygium: a randomized clinical trial.

Autor: Cioba C; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Marafon SB; Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos, Porto Alegre, RS, 90035-903, Brazil. oft.samara@gmail.com.; Oftalmocentro, Porto Alegre, RS, Brazil. oft.samara@gmail.com., Fortes BGB; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Cavalheiro MT; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.; Oftalmocentro, Porto Alegre, RS, Brazil., Fabris M; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Michel G; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Zambon GM; Hospital São José, Criciuma, SC, Brazil., Marcon A; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Marinho DR; Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos, Porto Alegre, RS, 90035-903, Brazil.; Oftalmocentro, Porto Alegre, RS, Brazil.
Jazyk: angličtina
Zdroj: International ophthalmology [Int Ophthalmol] 2023 Jul; Vol. 43 (7), pp. 2371-2381. Date of Electronic Publication: 2023 Jan 18.
DOI: 10.1007/s10792-023-02635-z
Abstrakt: Purpose: To describe and compare the autologous fibrin glue and traditional sutures for conjunctival graft attachment in patients undergoing primary pterygium excision surgery.
Method: A randomized clinical trial included patients who underwent pterygium surgery with conjunctival autologous graft (CAG). Using randomization, a single-trained surgeon performed graft fixation with autologous glue or sutures. The glue was prepared immediately before the surgery, using the patient's blood components. After centrifugation, the plasma was collected and enhanced with calcium gluconate. Postoperative assessments were performed on Days 1, 7, 21, 30 and 180. The study evaluated postoperative edema and pain and complications. The mean surgical time was compared. Recurrence of the pterygium was assessed 6 months postoperatively.
Results: The study evaluated 61 eyes. Thirty-three eyes underwent pterygium surgery using the glue technique, and 28 underwent the traditional suture technique. Fifty-one patients (83.60%) had successful graft adhered to at the end of follow-up. Ten patients (10/33) lost their graft in the glue group, and only 69.70% maintained graft presence in the fourth week versus 100% of the patients in the suture group (p = 0.001). Pain scores were lower in the glue group, and clinical edema was significantly higher. There was no significant difference in graft retraction or the presence of granuloma, necrosis or postoperative infection.
Conclusion: Autologous fibrin glue is an affordable option for CAG fixation in particular contexts where commercial fibrin glue is unavailable, and it could offer advantages compared to sutures. A higher graft loss rate was observed and might be related to topical anesthesia, and improvements to the technique are needed.
Clinicaltrials: gov Identifier: NCT04151017. https://clinicaltrials.gov/ct2/show/NCT04151017?term=20170467&draw=1&rank=1 .
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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