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Hsi-Wei Chung, Jod S. Mehta; Feasibility of Fibrin Glue in Gundersen Flap Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1965.
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Fibrin glue is a suitable alternative to conventional sutures in Gundersen flap surgery
This is a prospective, non-comparative interventional case series of patients who have undergone conjunctival flap surgery using fibrin glue by a single surgeon (J.M) at the Singapore National Eye Centre from January 2009 to August 2010.Patients with poor visual prognosis, requiring surgery for stabilization of the ocular surface or pain relief were included.Surgery first involved corneal epithelium debridement and later bulbar conjunctival dissection. Following a 270-degree limbal peritomy with two 45-degree relaxing incisions at 5 and 7 o’clock and limbal diathermy, the conjunctiva flaps were mobilized over the corneal surface without tension. Fibrin glue was then used to adhere them to the corneal surface as opposed to sutures in conventional surgery. Topical steroid and antibiotic eyedrops were started post operatively.
4 eyes of 4 patients were included in the study. The mean age of the patients were 63.3 years (range 60.1-68.9yrs). All patients were of Chinese ethnicity. Mean duration of follow-up was 10.2 months. Preoperative visual acuity was PL in 3 eyes and NPL in 1 eye. Patient demographics, diagnoses and surgical indications are summarized in Table 1.Mean operating time was 31 min (range 20-43 min). Surgical success (ocular surface stability and pain relief) was achieved in all eyes with significant reduction in ocular surface inflammation. No retractions were noted and recovery uncomplicated(Figure 1). Visual acuity was also unchanged post operatively for 3 patients and improved in the 3rd.
Fibrin glue application is a viable alternative to sutures in Gundersen flap surgery as it reduces surgical downtime, gives faster ocular surface rehabilitation and offers similar outcomes to conventional conjunctival flap surgery
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