Utilização de adesivo de fibrina em cirurgias oftalmológicas

Pizzol, Melissa Manfroi Dal; Roggia, Murilo Felix; Kwitko, Sérgio; Marinho, Diane Ruschel; Rymer, Samuel

doi:10.1590/s0004-27492009000300006

Cited by 55 publications

(11 citation statements)

References 21 publications

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“…When wide excisions are necessary for tumor surgery, autologous graft or labial mucosa can be used for surface reconstruction [1]. An alternative is the use of amniotic membrane graft, which has been used in ocular surface reconstruction in surgical scarring diseases of the cornea and conjunctiva [2,3,4,5,6,7,8]. The amniotic membrane is the innermost layer of the placenta and is a thick basal membrane with an avascular stroma [1].…”

Section: Introductionmentioning

confidence: 99%

“…This substance is a bioadhesive material which mimics the reactions involved in the coagulation cascade promoting polymerization of fibrinogen by thrombin, which leads to the formation of clot fibrin. Thus, its application is an alternative to sutures [4,5]. …”

Section: Introductionmentioning

confidence: 99%

“…The first component is human plasma rich in fibrinogen, diluted in a solution of aprotinin. The second is a solution of thrombin and calcium chloride [5,6]. …”

Section: Introductionmentioning

confidence: 99%

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Surgical Reconstruction of Ocular Surface Tumors Using Fibrin Sealant Tissue Adhesive

2016

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Purpose: To evaluate the surgical outcomes of ocular surface reconstruction in corneal-conjunctival tumors using fibrin tissue adhesive. Methods: A prospective noncomparative study was performed between May 2013 and February 2015. Patients were submitted to routine surgical procedure for corneal-conjunctival tumor excision followed by amniotic membrane graft transplantation using fibrin tissue adhesive (Evicel®, Omrix Biopharmaceuticals Ltd., Israel). Results were assessed on the 1st, 7th, 15th and 30th postoperative days to analyze subjective complaints, adhesiveness and positioning of the graft, potential complications and recurrences. Results: Twenty-five eyes were analyzed (male, 14). The diagnosis after the treatment was categorized as squamous cell neoplasia, dysplasia, actinic keratosis, squamous papilloma and compound melanocytic nevus. Few significant symptoms were reported, such as mild hyperemia and ocular dyscomfort. One case developed a conjunctival granuloma which regressed after topical treatment. All grafts were successful with no displacements or retraction postoperatively. There was no clinical recurrence of the tumor in a mean time of follow-up of 11 months. Conclusion: Fibrin tissue adhesive is safe and effective in the surgery of ocular surface tumor. In this series, sutureless amniotic membrane transplantation using fibrin glue has the potential to shorten the surgical time, mitigate inflammation postoperatively and improve patient discomfort.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Reconstruction of Ocular Surface Tumors Using Fibrin Sealant Tissue Adhesive

2016

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“…Thus, it aims to provide adhesion between tissues during surgical procedures as an alternative to sutures. Additionally, it provides several benefits in terms of tissue regeneration, reducing surgical time, the friction and tension applied to tissues, tissue necrosis, inflammation, the risk of infection, and the formation of foreign body granuloma, thus providing greater patient comfort (4,5) . However, the surgeon needs to be experienced in the technique and has to handle the glue swiftly due to its fast precipitation (6) .…”

mentioning

confidence: 99%

“…In ophthalmology, fibrinogen adhesives have been tested in various surgical procedures, such as: amniotic membrane fixation and autologous conjunctival grafting for pterygium, limbal transplantation, lamellar keratoplasty, reconstruction of the ocular surface, glaucoma surgery, cataract surgery, phacoemulsification with scleral tunnel, corneal perforations, oculoplastic surgery, conjunctival surgery, radial keratotomy, lamellar grafting, penetrating keratoplasty, refractive surgery, and even surgery for superficial burns (5,7) .…”

mentioning

confidence: 99%

Estudo descritivo de cirurgia de pterígio primário com adesivo de fibrina

Pereira¹,

Vieira²,

Leite³

et al. 2013

Rev. bras.oftalmol.

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RESUMOObjetivo: Avaliar a técnica cirúrgica de exérese de pterígio primário com adesivo de fibrina, quanto à sintomatologia e dados epidemiológicos. Métodos: Ensaio clínico prospectivo, não-controlado e aleatório com 30 pacientes do Hospital Universitário Lauro Wanderley, concordantes com o termo de consentimento livre e esclarecido, aprovado pelo Comitê de Ética em Pesquisa. As cirurgias foram avaliadas nos 1 º , 7 º e 21 º pós-operatório (PO). Resultados: Dos 30 pacientes operados, 16 (53,3%) eram do sexo feminino, com idade variando de 21 a 67 anos (42,2). Quanto à graduação do pterígio (1 a 3): grau 1-10 (33,3%), grau 2-10 (33,3%) e grau 3-10 (33,3%), sendo 16 (53,3%) no olho direito e 14 (46,7%) no olho esquerdo. 56,7% dos pacientes afirmaram intensa exposição solar durante a vida e possuíam casos semelhantes na família. No transoperatório, houve queixas de dor (43,3%) e sensação de corpo estranho (46,7%). O tempo cirúrgico variou de 11 a 32 minutos (17,7). As queixas no 1 º , 7 º e 21 º PO, respectivamente, foram: dor (60%, 26,6% e 6,66%), hiperemia (93,3%, 66,6% e 36,6%), sensação de corpo estranho (53,3%, 46,6% e 20%), epífora (83,3%, 43,3% e 6,66%), secreção (33,3%, 36,6% e 6,66%), ardência (53,3%, 36,6% e 16,6%) e olho seco (6,66%, 26,6% e 23,3%). 43,3% afirmaram estar muito satisfeitos com a cirurgia e 63,8% consideraram o aspecto estético excelente. Três pacientes (10%) não compareceram ao 7 DPO e 5 (16,6%) ao 21 DPO. Não houve perda do enxerto nos casos estudados. Conclusão: O transplante autólogo de conjuntiva é atualmente a alternativa mais eficaz para o tratamento do pterígio. Associado ao uso do adesivo de fibrina, que é composto de fibrinogênio e trombina e tem a vantagem de ser totalmente absorvível, apresenta vantagens, dentre elas a redução do tempo cirúrgico. Neste estudo, corroborando com estudos recentes, o tempo cirúrgico médio foi 19,05 (±6,1) minutos e houve alta incidência de familiares portadores de pterígio e exposição aos raios ultravioleta. A queixa de olho seco aumentou progressivamente após a cirurgia, revelando uma possível alteração do ritmo do piscar. Pouco abordada na literatura, a sintomatologia avaliada neste estudo, mostrou que as queixas leves transoperatórias e acentuadas no 1 º DPO, regrediram a partir do 7 º DPO, justificando a maior satisfação dos pacientes e o excelente aspecto estético referido com o uso desta técnica.Descritores: Pterígio; Transplante autólogo; Espuma de fibrina; Epidemiologia; Sintomas locais (93,3%, 66,6% e 36,6%), foreign body sensation (53,3%, 46,6% e 20%), epiphora (83,3%, 43,3% e 6,66%), discharge (33,3%, 36,6% e 6,66%),burning (53,3%, 36,6% e 16,6%) and dry eye (6,66%, 26,6% e 23,3%

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A Novel Technique of Modified Continuous Blanket Suture for Amniotic Membrane Fixation in Severe Ocular Surface Diseases

Zhang

Chen

et al. 2013

JAMA Ophthalmol

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Human amniotic membrane (AM) transplantation (AMT) has been widely used to treat various ocular surface diseases (OSDs) because of its unique properties. 1-3 The firm fixation of the AM to the ocular surface is a prerequisite for providing a stable basement membrane for epithelial cell migration and propagation before complete epithelialization is achieved. 4 The literature describes several techniques to fix the AM. Traditional suture techniques for AM fixation are the interrupted suture, a continuous (or running) suture, or a combination of these techniques. Recently, sutureless techniques, such as tissue adhesives and diverse ring-AM complexes, have been introduced and tested in different studies. 5,6 Cautery was also used in pterygium surgery. 7 However, there are a number of complications and inherent drawbacks associated with those fixation methods, 3,8 especially in cases of severe OSD. In severe patients, the AM could dissolve or be lost early because of serious inflammation. Some patients may need repeated AMT. Thus, it is necessary to develop new AM fixation techniques to overcome these drawbacks. Since 2002, we have routinely used a modified continuous blanket suture (MCBS) technique to anchor the AM in more than 300 cases with various OSDs. In this article, typical cases are presented to demonstrate the application of these new techniques in different zones of ocular surface defects caused by severe OSD. Methods This study was approved by the review ethics committee of the Eye Hospital of Wenzhou Medical College, and all of the subjects or their legal guardians signed their written informed consent to participate. The AM was thawed and trimmed to fit the size and shape of the lesion. The amnion patch was used to cover the entire ocular surface of all of the severe lesions, with the epithelial surface side up. The AM was sutured to the perilimbal episclera and to the bulbar conjunctiva using 2 circumferential 10-0 nylon sutures in the manner described here (Figure 1). The first needle entered from the limbus at 9 o'clock (right eye) or 3 o'clock (left eye), passed through the episclera, and then exited from the bulbar conjunctiva at 2 to 3 mm. The suture was made Video at jamaophthalmology.com

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Utilização de adesivo de fibrina em cirurgias oftalmológicas

Abstract: Despite the limitations related to the retrospective and non-comparative setting, this study suggests that the use of fibrin glue seems to be safe and effective for tissue fixation or incisional closure presenting low rates of complications in ocular surface and anterior segment surgeries.

Cited by 55 publications

References 21 publications

Surgical Reconstruction of Ocular Surface Tumors Using Fibrin Sealant Tissue Adhesive

Surgical Reconstruction of Ocular Surface Tumors Using Fibrin Sealant Tissue Adhesive

Estudo descritivo de cirurgia de pterígio primário com adesivo de fibrina

A Novel Technique of Modified Continuous Blanket Suture for Amniotic Membrane Fixation in Severe Ocular Surface Diseases

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