J Korean Ophthalmol Soc.  2010 Apr;51(4):498-503. 10.3341/jkos.2010.51.4.498.

The Efficacy of Fibrin Glue in Surgical Treatment of Conjunctivochalasis With Epiphora

• Nam K
• Jo YJ
• Lee SB

• KMID: 2213389
• DOI: http://doi.org/10.3341/jkos.2010.51.4.498

Abstract

PURPOSE
To investigate the efficacy of fibrin glue used in conjunctival resection for conjunctivochalasis with epiphora.
METHODS
Twenty-three patients (42 eyes) with conjunctivochalasis without nasolacrimal duct obstruction underwent conjunctival resection using either absorbable sutures (11 patients, 20 eyes, Group 1) or fibrin glue (12 patients, 22 eyes, Group 2) to attach the conjunctiva to the sclera. Outcomes recorded were improvement of epiphora, postoperative discomfort, and operation time. Postoperative discomfort was analyzed only in one eye (right eye) in case that the both eyes were operated.
RESULTS
Epiphora completely improved in 6 eyes (30%) in Group 1 and 8 eyes (36.4%) in Group 2, partially improved in 9 eyes (45%) and 8 eyes (36.4%), and did not improved in 5 eyes (25%) and 6 eyes (27.2%), respectively (p=1.000). On the first day postoperatively, postoperative eye discomfort developedin 7 eyes (63.6%) in Group 1 and 5 eyes (41.7%) in Group 2 (p=0.414). Throughout the following week, the discomfort lasted in 6 eyes (54.5%) in Group 1 and 1 eye (13.6%) in Group 2 (p=0.027). The mean operation time was 25.0 (+/-2.6) minutes in Group 1 and 12.0 (+/-2.4) minutes in Group 2 (p<0.001).
CONCLUSIONS
The success rates were similar in the two groups. However, the use of fibrin glue significantly reduces the postoperative discomfort and the operation time. Therefore, the use of fibrin glue in conjunctival resection of conjunctivochalasis seems to be an effective method.

Keyword

Conjunctivochalasis; Conjunctival resection; Fibrin glue

MeSH Terms

Conjunctiva
Eye
Fibrin
Fibrin Tissue Adhesive
Humans
Lacrimal Apparatus Diseases
Nasolacrimal Duct
Sclera
Sutures
Fibrin
Fibrin Tissue Adhesive

Figure

• 

  Figure 1. An example of conjunctivochalasis. The lacrimal punctum is covered with lax conjunctiva (arrow).

• 

  Figure 2. Photographs demonstrating the fibrin glue technique. (A) Component 1 (human fibrinogen, aprotinin) was instilled first after drying up the sclera surface, (B) which was followed by subsequent dropping of component 2 (thrombin, CaCl2). (C) Resected conjunctival edges were tightly approximated with forceps and pressure was given with cotton tip to fix the conjunctiva on the sclera.

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  Figure 3. Photograph of a patient after conjunctival resection with fibrin glue technique. The conjunctiva is well attached without laxity by fibrin glue at post-operative day 1.

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  Figure 4. Photographs of a patient with wound dehiscence. A wound gap is observed on the first day of conjunctival resection with fibrin glue. The eye recovered without any treatment 4 weeks later.

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  Figure 5. Improvement of epiphora after surgery in 2 groups. Success rate of group 1 and group 2 is 75% and 72.8% respectively, and there is no significant difference in the success rate between the two groups(p=1.000).

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  Figure 6. Incidence of foreign body sensation or ocular pain after surgery. On the first day, there is no significant difference in the incidence between the two groups but on the first week the incidence in group 2 was significantly lower than in group 1 (* p<0.05, chi-square test).

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  Figure 7. Average operation time in the two groups. The operation time in group 2 is significantly shorter than in group 1 (* p<0.05, Mann-Whitney U test).

Reference

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