Pterygium: Surgical Strategies for Success
Dr. Hovanesian reveals his techniques for successful pterygium surgery. His recommendations include using Fibrin tissue adhesive and amniotic membrane transplantation.
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Comments (15)
In this video we show Evicel* (Ethicon, Johnson & Johnson), which comes frozen in two separate vials. Once thawed, each component (thrombin and fibrinogen) is then drawn into a separate 1 cc syringe via an 18 gauge needle. They are delivered separately onto the eye, as shown in the video, directly from the hub of each syringe. I believe there is a variety of Tisseel* that comes in two separate vials. These must be mixed and warmed up in a "fibrinotherm" device (free from Baxter). Once prepared, these can be used in the same manner described above. *please note this describes an off-label (not FDA approved) use of Evicel and Tisseel
How did you separate the components of the Tisseal?
bravo
Gustavo, after surgery I have patients wear a patch overnight only.
Some doctors advice to maintanin eye occlusion during 7 days to help de autograft to survive.What do you think about that? gustavo
A reasonable suggestion to take the graft from below. Surgically, it is more challenging to get a thin graft from this location, just for reasons of ergonomics. However, it offers the advantage of leaving the superior conjunctiva untouched for future glaucoma surgery. That said, glaucoma surgery can (and many times has been) successfully performed in superior limbal areas that were once treaded upon by corneal surgeons harvesting an autograft.
why not take the conj graft from below?
VERY COMPLETE VIDEO, THANK YOU FOR SHARING!
Thanks for producing a very informative video with excellent take home messages
Nice, thank you.
Very good experience.
Thanks for an excellent video!
Thanks for your kind comments. In autograft surgery, the donor site at the superior limbus will spontaneously epithelialize within a week or so after surgery. Some surgeons like to place a drop of fibrinogen on this site at the conclusion of surgery (without thrombin) to act like a fibrin bandage and enhance comfort during healing.
great video. thank you. how do you manage the harvesting site of conjunctiva in the case of autograft?
Great Video! Thanks for your great expertise.