Recurrence Rate Using Fibrin Glue-Assisted Ipsilateral Conjunctival Autograft in Pterygium Surgery: 2-Year Follow-up

Purpose To compare 4 limbal-conjunctival autograft fixation techniques—conventional suture, commercial fibrin glue, autologous fibrin glue, and cautery—in primary nasal pterygium surgery. Methods This is a retrospective and descriptive study. The postoperative patient discomfort, graft edema, ocular inflammation, and other complications of 4 limbal-conjunctival autograft fixation techniques in primary nasal pterygium surgery were evaluated. Results Postoperative patient discomfort was significantly lower with the sutureless techniques (p<0.001), with fixation with cautery having the lowest rate of discomfort. Graft edema and ocular inflammation during the early postoperative period were significantly higher when fibrin glue techniques were used (p<0.001). The recurrence rate did not show a statistically significant difference (p = 0.682) among the 4 groups. Conclusion In primary nasal pterygium surgery, limbal-conjunctival autograft fixation using cautery is the technique with the lowest postoperative discomfort rate and without a statistically significant increase in recurrence rate when compared to conventional suture and fibrin glue techniques.

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Recurrence Rate and Graft Stability With Fibrin Glue Compared With Suture and Autologous Blood Coagulum for Conjunctival Autograft Adherence in Pterygium Surgery

Cornea ◽

10.1097/ico.0000000000001270 ◽

2017 ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

Rituparna Maiti ◽

Somnath Mukherjee ◽

Debasish Hota

Keyword(s):

Recurrence Rate ◽

Fibrin Glue ◽

Autologous Blood ◽

Conjunctival Autograft ◽

Pterygium Surgery

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Outcomes of Vertical Split Conjunctival Autograft Using Fibrin Glue in Treatment of Primary Double-Headed Pterygia

Journal of Ophthalmology ◽

10.1155/2018/9341846 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Tarek Roshdy Elhamaky ◽

Ahmed Mohammed Elbarky

Keyword(s):

Fibrin Glue ◽

Fibrous Tissue ◽

Effective Technique ◽

Normal Appearance ◽

Conjunctival Autograft ◽

Donor Area ◽

Good Cosmetic ◽

Pterygium Surgery ◽

Pterygium Excision

Purpose. To evaluate the efficiency of pterygium excision with the vertical split conjunctival technique using fibrin glue in treatment of primary double-headed pterygia. Patients and Methods. 15 eyes of 15 patients with primary double-headed pterygia that underwent vertical split conjunctival autograft pterygium surgery were retrospectively reviewed. Recurrence was defined as fibrovascular proliferation over the limbus onto the cornea. Results. The patients’ mean age was 36.92 ± 10.8 years. At 12-month follow-up, recurrence was not seen in any cases. Regarding postoperative cosmetic grading, grade 1 (the appearance of the operated site is not different from the normal appearance) was found in 12 eyes (80%) and grade 2 (some fine episcleral vessels in the excised area extending up to but not beyond the limbus and without fibrous tissue) was found in 3 eyes (20%). None of the cases showed conjunctival scarring or fibrosis at the conjunctival donor area. Preoperative Sim K astigmatism at the central 3 mm and BCVA were 3.05 ± 1.5 diopters (D) and 0.64 ± 0.26 logMAR, which improved significantly to 1.15 ± 0.84 D and 0.26 ± 0.18 logMAR at 12-month follow-up postoperatively, respectively. Conclusion. Vertical split conjunctival autograft using fibrin glue is an effective technique with good cosmetic results and low to no recurrence for primary double-headed pterygia treatment. This trial is registered with NCT03507283.

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Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

International Eye Research ◽

10.18240/ier.2021.03.01 ◽

2021 ◽

Vol 2 (3) ◽

pp. 123-126

Author(s):

Tian-Yu Wang ◽

◽

Min Yang ◽

Yi Zhang ◽

Zhao-Yang Wang ◽

...

Keyword(s):

Recurrence Rate ◽

Case Series ◽

Operation Time ◽

Recurrence Time ◽

Conjunctival Autograft ◽

Long Term Follow Up ◽

Pterygium Surgery ◽

Limbal Conjunctival Autograft ◽

Primary Pterygium

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

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Pterygium surgery using a conjunctival autograft

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-174-178 ◽

2021 ◽

pp. 174-178

Author(s):

M.G. Kataev ◽

◽

M.A. Zakharova ◽

I.U. Trofimova ◽

A.V. Shakhmatova ◽

...

Keyword(s):

Postoperative Complications ◽

Effective Treatment ◽

Recurrence Rate ◽

Intraoperative Complication ◽

Conjunctival Autograft ◽

Common Technique ◽

Pterygium Surgery ◽

Pterygium Excision ◽

Different Sources

Surgery is the only effective treatment for pterygium. The most common technique is the use of a conjunctival autograft after excision of the pterygium. However, the frequency of recurrences of this method, as well as possible complications in different sources, are different. Purpose. To evaluate the efficacy, safety and recurrence rate of conjunctival autograft after pterygium excision. Material and methods. 101 patients with pterygium. aged 57.31 ± 14.7 years. The follow-up period was 1 year in 56 patients and 2 years in 45 patients. All patients underwent excision of the pterygium with conjunctival autograft. Results. An intraoperative complication can be attributed to the insufficient area of the autoconjunctival graft during its transfer to the sclera, which occurred in three patients. Postoperative complications: graft edema in 14 cases (13.86%), granuloma in the suture area was observed in 1 case (0.99%). Recurrence of pterygium was noted in only three cases (2.97%). Conclusion. The use of a conjunctival autograft in pterygium surgery has shown its effectiveness and safety, as well as a low recurrence rate. The donor zone in the upper and lateral makes it possible to excise a sufficient area of autoconjunctival graft with preservation of the intact area of possible future surgery for glaucoma. Key words: conjunctival autograft, pterygium, recurrence of pterygium.

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Facilitated Tenon-Free Conjunctival Autograft Preparation and Limited Tenon Removal Technique in Pterygium Surgery

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1648-4753 ◽

2021 ◽

Author(s):

Fikret Ucar ◽

Lutfi Seyrek ◽

Servet Cetinkaya ◽

Huseyin Ture ◽

Ekrem Kadioglu

Keyword(s):

Recurrence Rate ◽

Conjunctival Autograft ◽

Operation Duration ◽

Pterygium Surgery ◽

The Mean ◽

Pterygium Excision ◽

Group 2 ◽

Removal Technique ◽

Group 1

Abstract Background The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration. Material and Methods This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017. Results The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 – 7) minutes in group 1 and 8.23 ± 1.26 (8 – 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001). Conclusions The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.

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