The Efficacy of Fibrin Sealant in Sutureless Deep Sclerectomy-Preliminary Outcomes.

IF 2 4区 医学 Q2 OPHTHALMOLOGY
Journal of Glaucoma Pub Date : 2024-09-01 Epub Date: 2024-04-01 DOI:10.1097/IJG.0000000000002380
Alina-Dana Baxant, Martin Pencak, Jana Vranova, Magdalena Netukova, Katarina Urbaniova, Lucie Holubova, Patrik Pluhovsky, Jozef Rosina, Pavel Studeny
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Abstract

Prcis: Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively.

Objective: To evaluate short and medium-term postoperative results of DS with a fibrin sealant.

Patients and methods: This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery.

Results: The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively ( P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery ( P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes.

Conclusions: Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.

纤维蛋白密封剂在无缝合深巩膜切除术中的疗效--初步结果。
Prcis:目的:评估使用纤维蛋白粘合剂进行深巩膜切除术(DS)的短期和中期术后效果:这项前瞻性、非比较性、介入性病例系列研究涉及 12 位未受控制的开角型青光眼(OAG)患者的 12 只眼睛,这些患者在 2021 年 2 月至 2022 年 3 月期间接受了植入 Esnoper(Clip 或 V2000)的深巩膜切除术。采用纤维蛋白胶代替传统缝合线的新型伤口闭合方法(巩膜、腱膜筋膜和结膜)。手术效果评估包括:眼内压(IOP)和青光眼治疗(GT)降低、最佳矫正视力(BCVA)变化以及术前术后登记的并发症数量。所有测量均在术前、术后1天、1周和2周、1个月、2个月、3个月、6个月、9个月和12个月进行:结果:平均眼压从 24.0±9.1 mmHg 降至术后一年时的 13.8±6.3 mmHg(PC 结论:纤维蛋白粘合剂能有效粘合眼球:在我们的研究中,纤维蛋白粘合剂为无缝线DS患者提供了有效的闭合。这种对传统 DS 的改良可简化手术技巧、确保伤口安全适应、优化愈合并降低术后炎症和纤维化的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Glaucoma
Journal of Glaucoma 医学-眼科学
CiteScore
4.20
自引率
10.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
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