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A comparative study of conventional intermarginal split lamella with labial mucous membrane graft versus sutureless procedure using fibrin sealant to manage major trichiasis

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Abstract

Objective

In the intermarginal split lamella with labial mucous membrane graft procedure to manage major trichiasis, the graft is usually sutured in the receptor bed using 6–0 polyglactin sutures. We aimed to compare the use of fibrin sealant to seal the graft to the receptor bed versus the conventional technique using sutures.

Methods

This is a retrospective comparative study of patients who underwent conventional intermarginal split lamella with labial mucous membrane graft or sutureless procedure using fibrin sealant (Tisseel, Baxter Healthcare Corp) between 2016 and 2021. Etiology of the trichiasis, procedure duration, postoperative discomfort and edema, complications, and follow-up period were extracted from these patients’ charts.

Results

Twenty-seven eyelids from 19 patients underwent the procedure: twelve patients underwent the sutureless procedure, while seven underwent the conventional procedure. Mean follow-up was 8.4 ± 2.9 months and 13.7 ± 6.5 months for the sutureless and conventional groups, respectively. Patients who underwent the sutureless procedure reported no postoperative foreign body sensation, while 71.4% of patients who underwent the conventional procedure reported some degree of ocular discomfort. In the sutureless group, operating time and postoperative edema were significantly reduced. Labial mucous membrane graft dehiscence was observed in one eyelid (8.3%) on the first postoperative day in the sutureless group. No dehiscence was observed in the conventional technique group.

Conclusion

The use of fibrin sealant showed to be a good alternative to conventional absorbable sutures. Advantages include expedited operating time, decreased postoperative discomfort, and expedite postoperative recovery.

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Authors and Affiliations

  1. Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo EPM/UNIFESP, R. João Moura, 661 cj 84, São Paulo, SP, Brazil

    Lilian E. Ohkawara, Midori H. Osaki, Patricia Y. Miyasato & Tammy H. Osaki

  2. Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Brigadeiro Hospital, São Paulo, SP, Brazil

    Lilian E. Ohkawara & Stephanny M. Alves

Authors
  1. Lilian E. Ohkawara
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  2. Midori H. Osaki
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  3. Stephanny M. Alves
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  4. Patricia Y. Miyasato
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  5. Tammy H. Osaki
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Contributions

LEO: acquisition, analysis, and interpretation of data; drafting the work; final approval. MHO: design and conception of the study; analysis, and interpretation of data; critical revision for important intellectual content; final approval. SMA: acquisition, analysis, and interpretation of data; critical revision for important intellectual content; final approval. PYM: acquisition, analysis, and interpretation of data; critical revision for important intellectual content; final approval. THO: design and conception of the study; analysis, and interpretation of data; critical revision for important intellectual content; final approval.

Corresponding author

Correspondence to Tammy H. Osaki.

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All authors have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the UNIFESP IRB (CAAE 52823521.7.0000.5505) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ohkawara, L.E., Osaki, M.H., Alves, S.M. et al. A comparative study of conventional intermarginal split lamella with labial mucous membrane graft versus sutureless procedure using fibrin sealant to manage major trichiasis. Int Ophthalmol 43, 1459–1463 (2023). https://doi.org/10.1007/s10792-022-02541-w

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  • DOI: https://doi.org/10.1007/s10792-022-02541-w

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