目的:在翼状胬肉切除联合自体角膜缘移植手术中,比较运用纤维蛋白胶和缝线固定两种方法的手术安全性和有效性。方法:采用前瞻性的研究。随机选取58例因鼻侧初发性翼状胬肉而进行手术的58只患眼。翼状胬肉切除后取位于颞上侧角膜缘处的自体结膜移植片以覆盖巩膜创口。58例眼分为两组,每组29例。翼状胬肉切除后,组1用纤维蛋白胶(Beriplast P)固定结膜,而组2采用8-0缝线固定结膜。术后观察患者≥6mo,对术后患者的不适感(疼痛、刺痛感、流泪)和显微镜下的检查(充血、水肿)进行评分,采用Mann-Whitney U法对两组间的差异进行统计学分析。结果:组1中有1例患者出现球结膜下出血,组2中有7例由于肉芽肿反应,于术后15d移除缝线。组1中患者的不适症状和显微镜下所见显著性优于组2。组1中有1例患者术后胬肉复发,组2中有2例复发。组1与组2比较,平均手术费用较高但手术时间明显缩短,且差异具有统计学意义(P<0.05)。结论:翼状胬肉切除后,运用纤维蛋白胶固定植片能显著地减少患者术后的疼痛,并有效地缩短手术时间。

AIM:To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft.METHODS:A prospective randomised clinical trial was carried out in 58 eyes of 58 patients operated for primary nasal pterygium.Autologous conjunctival graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision.In 29 eyes,the transplant was attached to the sclera with a fibrin tissue adhesive(Beriplast P) and in 29 eyes with 8-0 Virgin silk sutures.The Mann-Whitney U test was used for statistical analysis.Postoperative patient discomfort(pain,stinging,watering) and biomicroscopic findings(hyperemia,edema) were graded.Patients were followed up at least for six months.RESULTS:Subconjunctival hemorrhage occured under the graft in one patient in group 1.In seven cases of group 2,sutures were removed at the 15th day because of granulomatous tissue reaction.Patient symptoms were significantly less and biomicroscopic findings were better in group 1.Pterygium recurrence was seen in one case of group 1,and 2 cases of group 2.Average surgery cost was higher(P<0.05) and surgery time was shorter(P<0.05) in fibrin group.CONCLUSION:Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.

R779.6