Transplante autólogo de conjuntiva com uso de cola de fibrina em pterígios primários

Coral-Ghanem, Ramon; Oliveira, Renan F.; Furlanetto, Eduardo; Ghanem, Marcielle A.; Ghanem, Vinı́cius Coral

doi:10.1590/s0004-27492010000400010

Cited by 11 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Compared to other adhesives such as cyanoacrylate, fibrin glue has the advantage of being fully absorbable; it is therefore the first choice for use in biological tissues (9) . Commerciallyavailable fibrin adhesives consist of two compounds that, when mixed, promote the formation of a fibrin clot.…”

Section: Discussionmentioning

confidence: 99%

Estudo descritivo de cirurgia de pterígio primário com adesivo de fibrina

Pereira¹,

Vieira²,

Leite³

et al. 2013

Rev. bras.oftalmol.

View full text Add to dashboard Cite

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%

show abstract

Section: Discussionmentioning

confidence: 99%

Estudo descritivo de cirurgia de pterígio primário com adesivo de fibrina

Pereira¹,

Vieira²,

Leite³

et al. 2013

Rev. bras.oftalmol.

View full text Add to dashboard Cite

show abstract

“…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%

“…Postoperatively, it can cause foreign body sensation and its removal is discomfortable. Sutures may increase the chance of infections and when loose or unsecured should be compulsorily removed even when absorbable sutures are used [3,4]. …”

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%

“…Its use has been described for closure of the conjunctiva [3,4,5], glaucoma surgery [9], trophic ulcer or perforated cornea [10], closure of corneal and scleral tunnel, setting of autologous conjunctiva in pterygium surgery [3,4,11], fixation of amniotic membrane to the sclera and cornea [6], lamellar keratoplasty, limbal transplantation [7] and ocular surface reconstruction, but there are still few reports regarding its use in ocular surface tumor surgeries [5]. This study aims to evaluate the surgical outcomes of surface reconstruction in ocular surface tumors using fibrin sealant tissue adhesive.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Reconstruction of Ocular Surface Tumors Using Fibrin Sealant Tissue Adhesive

2016

View full text Add to dashboard Cite

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.

show abstract