Outcomes of Vertical Split Conjunctival Autograft Using Fibrin Glue in Treatment of Primary Double-Headed Pterygia

Elhamaky, Tarek Roshdy; Elbarky, Ahmed Mohammed

doi:10.1155/2018/9341846

Cited by 9 publications

(7 citation statements)

References 40 publications

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“…[1][2][3][4]11] Sun (ultraviolet light) exposure and exposure to environmental factors such as wind and dust increase the risk of these ocular surface diseases. [12][13][14][15][16] Huseyin Dundar et al investigated the effects of using soft contact lenses on pinguecula prevalence. [6] Recently, AF was introduced as a noninvasive imaging modality for the diagnosis and follow-up of several retinal disorders.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium

Beheshtnejad,

Ghassemi,

Abdolkhalegh

et al. 2023

JOVR

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Purpose: To assess the autofluorescence size and properties of pterygium and pinguecula by anterior segment autofluorescence (AS-AF) imaging and demonstrate the difference of autofluorescence size presented in AS-AF imaging compared to the extend size of the conjunctival lesion measured by anterior segment slit-lamp photography (AS-SLE). Methods: Twenty-five patients with primary pterygium and twenty-five with pinguecula were included in the study. In addition, 25 normal subjects were also enrolled as the control group. The AS-AF characteristics of pterygium and pinguecula lesions were analyzed. The size of lesions displayed in the AS-SLE photography versus the AS-AF images were also compared. AS-AF images were obtained using a Heidelberg retina angiograph which focused on the anterior segment. AS-SLE photography was acquired using a digital imaging system (BX900 HAAG-STREIT). Results: There were 44 (58.7%) male and 31 (41.3%) female patients; 19 (76%) and 20 (80%) patients had bilateral pterygium and pinguecula, respectively. All pinguecula lesions reflected hyperautofluorescence pattern in the AS-AF imaging. In 24 (96%) patients, the hyperautofluoresecence pattern was larger than the size of the clinical lesions displayed with the AS-SLE photography. Twenty-one (84%) patients with pterygium reflected a hyperautofluorescence pattern in AS-AF images; in one (4%) patient, the hyperautofluorescence pattern was larger than the clinical lesion size and four (16%) patients had no autofluorescence patterns in the AS-AF images. In the control group, in 14 (56%) subjects, a hypoautofluorescent pattern was revealed in the conjunctiva in AS-AF images. However, in 11 (44%) patients, hyperautofluorescence patterns were detected. Conclusion: AS-AF is a useful modality to monitor vascularization in conjunctival lesions. Pingueculae and pterygium show hyperautofluorescence in AS-AF imaging. The real size of the pinguecula lesions may be estimated with AS-AF characteristics, mostly presenting larger than the area size in AS-SLE photography. The autofluorescence size of the pterygium is smaller than the extent of visible pterygium in slit-lamp photography.

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Section: Discussionmentioning

confidence: 99%

Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium

Beheshtnejad,

Ghassemi,

Abdolkhalegh

et al. 2023

JOVR

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“…Another had similar recurrence rates for both groups [ 22 ]. A study by Tarek et al had 0% recurrence for double-headed pterygia that underwent vertical split conjunctival autograft using fibringlue [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…[ 22 ] shorter surgical time would make fibrin glue more cost-effective. It is also postulated as a contributing factor in reducing postoperative fibrosis at the donor area [ 6 ]. Our results concur with earlier reports which concluded that excision of pterygium leads to statistically significant reduction in astigmatism, which improves vision significantly [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of fibrin glue versus suture closure on double-headed pterygia in Asian eyes – a 7-year study in a tertiary institution

et al. 2021

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Background To compare the recurrence rate and outcomes of double-headed pterygia using fibrin glue versus suture closure of conjunctival autograft. Methods All patients with double-headed pterygia who underwent pterygia excision with conjunctival autograft from January 2012 to January 2019 in the National University Hospital of Singapore were included. Patients were divided into 2 groups depending on whether fibrin glue or sutures were used to secure the conjunctival autograft in place. All patients had a minimum of 6 months follow-up. Results A total (26 patients) of 22 eyes had fibrin glue, while eight eyes underwent suture closure of their conjunctival autograft. Fibrin glue group had 4.5% recurrence rate, while suture group had 37.5% recurrence rate ( p = .021). There is statistically significant improvement for overall visual acuity ( p = .009) and cylinder ( p = .002). There is also statistically significant improvement for visual acuity in the glue group ( p = .026), but not in the suture group. Fibrin glue group had a shorter operation duration time compared to suture group ( p < .001). There were no cases of graft dislocation, contraction or limbal stem cell deficiency. Conclusions Low recurrence rates and good postoperative visual outcomes can be achieved with the split conjunctival autograft technique. Our study suggests that fibrin glue has an additional benefit over the use of sutures in the management of these complex cases.

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“…Since then it has been thoroughly tested, showing that the limbal stem cells are maintained when cultivated on a fibrin substrate and that in more than 75% of cases at 10 years post-transplant [ 72 , 73 ], the corneal integrity of patients suffering from total limbal stem cell deficiency (LSCD) unresponsive to surgical therapy can be restored permanently when the transplantation of limbal stem cells cultured on a fibrin gel is performed. Fibrin also has many other applications, the most noteworthy in ophthalmology being fibrin glue for wound closure in numerous surgical procedures, where it often replaces sutures for an enhanced cosmetic result [ 74 , 75 ]. However, it has been shown that fibrin glue delays corneal epithelial cell growth and migration and should therefore be used with caution [ 76 ].…”

Section: Introductionmentioning

confidence: 99%

The Human Tissue-Engineered Cornea (hTEC): Recent Progress

Guérin

Le‐Bel

Desjardins

et al. 2021

IJMS

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Each day, about 2000 U.S. workers have a job-related eye injury requiring medical treatment. Corneal diseases are the fifth cause of blindness worldwide. Most of these diseases can be cured using one form or another of corneal transplantation, which is the most successful transplantation in humans. In 2012, it was estimated that 12.7 million people were waiting for a corneal transplantation worldwide. Unfortunately, only 1 in 70 patients received a corneal graft that same year. In order to provide alternatives to the shortage of graftable corneas, considerable progress has been achieved in the development of living corneal substitutes produced by tissue engineering and designed to mimic their in vivo counterpart in terms of cell phenotype and tissue architecture. Most of these substitutes use synthetic biomaterials combined with immortalized cells, which makes them dissimilar from the native cornea. However, studies have emerged that describe the production of tridimensional (3D) tissue-engineered corneas using untransformed human corneal epithelial cells grown on a totally natural stroma synthesized by living corneal fibroblasts, that also show appropriate histology and expression of both extracellular matrix (ECM) components and integrins. This review highlights contributions from laboratories working on the production of human tissue-engineered corneas (hTECs) as future substitutes for grafting purposes. It overviews alternative models to the grafting of cadaveric corneas where cell organization is provided by the substrate, and then focuses on their 3D counterparts that are closer to the native human corneal architecture because of their tissue development and cell arrangement properties. These completely biological hTECs are therefore very promising as models that may help understand many aspects of the molecular and cellular mechanistic response of the cornea toward different types of diseases or wounds, as well as assist in the development of novel drugs that might be promising for therapeutic purposes.

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Outcomes of Vertical Split Conjunctival Autograft Using Fibrin Glue in Treatment of Primary Double-Headed Pterygia

Cited by 9 publications

References 40 publications

Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium

Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium

Impact of fibrin glue versus suture closure on double-headed pterygia in Asian eyes – a 7-year study in a tertiary institution

The Human Tissue-Engineered Cornea (hTEC): Recent Progress

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