Elsevier

Ophthalmology

Volume 112, Issue 4, April 2005, Pages 667-671
Ophthalmology

Original article
Comparison of Fibrin Glue and Sutures for Attaching Conjunctival Autografts After Pterygium Excision

Presented in part at: Association of Researchers in Vision and Ophthalmology Annual Meeting, May, 2002; Fort Lauderdale, Florida.
https://doi.org/10.1016/j.ophtha.2004.08.028Get rights and content

Purpose

To compare the efficacy and safety of fibrin glue and suturing for attaching conjunctival autografts among patients undergoing pterygium excision.

Design

Prospective, randomized, interventional case series.

Participants

Twenty-two patients undergoing excision of primary pterygium.

Methods

A superior conjunctival autograft was harvested and transferred onto bare sclera after pterygium excision. Fibrin glue (Beriplast P) was used to attach the autograft in 11 eyes and nylon 10-0 suture was used to attach the autograft in 11 eyes. The patients were followed up for 2 months.

Main Outcome Measures

Graft success, recurrence rate, operating time, patient comfort.

Results

All conjunctival autografts in both groups were successfully attached and were intact after 2 months. The average operating time for the fibrin glue group was significantly shorter (P<0.001). Postoperative symptoms were fewer for the fibrin glue group than the suture group. One patient (9%) from the fibrin group experienced subconjunctival hemorrhage, and 1 patient (9%) from the suture group experienced partial graft dehiscence.

Conclusions

Fibrin glue is a safe and effective method for attaching conjunctival autografts. The use of fibrin glue results in shorter operating times and less postoperative discomfort.

Section snippets

Patients and Methods

Twenty-two consecutive patients with primary pterygia undergoing primary pterygium excision at the Philippine General Hospital from June to August 2001 were prospectively enrolled. A comprehensive medical and ocular history was obtained, including patient age, gender, family, medical and ocular history. Snellen visual acuity measurement, funduscopy, applanation tonometry, slit-lamp examination, and anterior segment photography were performed preoperatively. Patients with ocular pathology other

Results

Of the 22 patients, 13 were male (59%). The mean age was 45±20 years (range, 23–67 years). All patients completed the 2-month follow-up period. All pterygia were nasally located. The distribution of pterygium grading was similar for both groups (Table 1).

The mean surgical duration was 67.0±3.6 minutes for the suture group and 27.8±1.0 minutes for the FG group. The mean operating time was significantly shorter when FG was used instead of nylon sutures (P<0.001). Postoperatively, some amount of

Discussion

Pterygium recurrence is the most common complication of pterygium surgery and is a frequent source of frustration for patients and surgeons. The current major methods of recurrence prevention include use of mitomycin C (MMC), conjunctival autografting, and, more recently, amniotic membrane grafting.12, 19 A recent meta-analysis of pterygium recurrence after surgery concluded that simple bare sclera resection alone is associated with 6 times higher odds of pterygium recurrence if a conjunctival

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    Manuscript no. 2004-62.

    The authors have no financial interest in any of the products or devices mentioned in the article.

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