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

Kiyup Nam; Young Joon Jo; Sung Bok Lee

doi:10.3341/jkos.2010.51.4.498

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Nam, Jo, and Lee: The Efficacy of Fibrin Glue in Surgical Treatment of Conjunctivochalasis With Epiphora

Original Article

J Korean Ophthalmol Soc 2010;51(4):498-503.

Published online: 25 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.4.498

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

Kiyup Nam, MD¹, Young Joon Jo, MD^1,², Sung Bok Lee, MD^1,^2,

¹Department of Ophthalmology, Chungnam National University College of medicine, Daejeon, Korea

²Research Institute for Medical Science, Chungnam National University, Daejeon, Korea

Address reprint requests to Sung Bok Lee, MD, Department of Ophthalmology, Chungnam National Hospital #640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea Tel: 82-42-280-7604, Fax: 82-42-255-3745, E-mail: sblee@cnu.ac.kr

Received 24 July 2009 Accepted 19 January 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 post-operative discomfort and the operation time. Therefore, the use of fibrin glue in conjunctival resection of conjunctivochalasis seems to be an effective method.

Keywords: Conjunctivochalasis, Conjunctival resection, Fibrin glue

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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.

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.

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.

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).

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).

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).

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