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M. E. McChesney, C. Reilly, T. Q. Dang; VitagelTM vs. TisseelTM Tissue Adhesives in Ocular Surface Surgery: A Retrospective Analysis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5300.
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The use of tissue adhesives as adjunctives to ophthalmic surgery have been reported since 1968. This study looks at two fibrin based tissue adhesives with different sources of fibrinogen. TisseelTM (manufactured by Baxter) used pooled human fibrinogen, while VitagelTM (manufactured by Angiotech) uses autologous serum as the source of fibrinogen. The purpose of this study is to determine if there is a significant difference in the intra-operative and post-operative course of ocular surface surgery, specifically pterygium excision surgery when using either VitagelTM or TisseelTM. Specifically: is there a difference in operative time and presence of post operative pain? Is there a different rate of complications: to include graft dehiscence, infection or recurrence?
A review of medical records at Wilford Hall Medical Center was undertaken to find patients who had undergone surgery to excise pterygiums. Records were included if either VitagelTM or TisseelTM were used as the tissue adhesive. Operative report and post operative clinical notes were reviewed and the following information was collected for each patient. Time of operation, tissue glue used, intra-operative complications, post op pain, infection, graft dehiscence, recurrence of pterygium at 1, 3, 6 and 12 months post operatively. The data was then analyzed using simple student’s T-test to evaluate for statistically significant differences.
The average time of pterygium surgery for the TisseelTM group was 37 minutes, for the VitagelTM group, average time of 44 minutes, this was not found to be statistically significant (p: 0.28) There was no difference in the presence of post operative pain or infection. There was one case of graft dehiscence and one case of pterygium recurrence recorded among the patients that used Vitagel, however, this was not statistically significant (p=0.16).
While there was a recorded episode of a conjunctival autograft dehiscence and a pterygium recurrence in the group of patients who used an autologous serum based tissue adhesives (VitagelTM), there was not a statistically significant difference in the operative time, post-operative pain, pterygium recurrence rate or graft dehiscence rate when comparing VitagelTM and TisseelTM tissue adhesives in ocular surface surgery. Familiarity with the proper preparation of each of the tissue adhesives by both the surgeon and the operating room staff is an important factor in the choice of a tissue adhesive for efficient and effective surgery.
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