Randomized interventional trial comparing conjunctival autograft secured with Sutures versus fibrin glue in primary pterygium excision

Abstract Background: To compare conjunctival autograft and combined amniotic membrane mini-simple limbal epithelial transplant after primary pterygium excision Methods: A prospective randomized interventional study was conducted on 264 eyes with Primary Pterygium.The patients were divided into Group I (conjunctival autograft) and Group II (mini-simple limbal epithelial transplant). 133 eyes in Group I underwent pterygium excision with a conjunctival autograft using fibrin glue. 131 eyes in Group II underwent mini Simple Limbal Epithelial Transplant with amniotic membrane using fibrin glue. Post-operatively, the patients were reviewed on day 1,3,7,14 & 30 and then at three,six and nine months. Primary outcome measure was the recurrence rate whereas the secondary outcome measures were the intraoperative time and other complications.Recurrence rate was calculated using Fisher’s exact test. Variables like age , preoperative BCVA , operative time and the dimensions of graft were compared using unpaired t test . Other baseline characteristics like gender, Laterality, grades of pterygium(I-III),Occupation and indication of surgery were expressed between the two groups using Pearson’s Chi-Square test. Results: Two hundred and thirty three eyes(118 in group I and 115 in group II) could complete nine months follow-up period. Recurrence was seen in 2(1.6%) cases in group I whereas 3 cases (2.6%) had recurrence in group II(p=0.681).Operative time for group (II) (20.33±1.28 min) was significantly higher (p<0.001) than group I (12.01±1.26). Graft displacement occurred in one case in group II (p=0.999). Conclusions: Despite a longer time,(p<0.001) mini-SLET seems to be a viable and equally effective alternative to CAG in the management of primary pterygium ,especially in cases where conjunctiva needs to be spared.Ethical Clearance Certificate Number : 29/MH/2015 dated 11 Aug 2015

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Recurrence After Primary Pterygium Excision: Amniotic Membrane Transplantation with Fibrin Glue Versus Conjunctival Autograft with Fibrin Glue

Current Eye Research ◽

10.3109/02713683.2014.999947 ◽

2015 ◽

Vol 41 (1) ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Ebru Toker ◽

Muhsin Eraslan

Keyword(s):

Fibrin Glue ◽

Amniotic Membrane ◽

Amniotic Membrane Transplantation ◽

Conjunctival Autograft ◽

Pterygium Excision ◽

Primary Pterygium

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Surgical Outcome of Primary Pterygium Excision with Conjunctival Autograft

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2015.56.6.856 ◽

2015 ◽

Vol 56 (6) ◽

pp. 856 ◽

Cited By ~ 1

Author(s):

Dong Ik Kim ◽

Mee Kum Kim ◽

Won Ryang Wee ◽

Joo Youn Oh

Keyword(s):

Surgical Outcome ◽

Conjunctival Autograft ◽

Pterygium Excision ◽

Primary Pterygium

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Comparison of de-epithelialized amniotic membrane transplantation and conjunctival autograft after primary pterygium excision

Eye ◽

10.1038/sj.eye.6702453 ◽

2006 ◽

Vol 22 (1) ◽

pp. 107-112 ◽

Cited By ~ 15

Author(s):

F Memarzadeh ◽

A K Fahd ◽

N Shamie ◽

R S Chuck

Keyword(s):

Amniotic Membrane ◽

Amniotic Membrane Transplantation ◽

Conjunctival Autograft ◽

Pterygium Excision ◽

Primary Pterygium

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Comparing Adjuvant Beta Radiation, Mitomycin C, and Conjunctival Autograft in Primary Pterygium Treatment, a Three-year Follow-up Study

The Open Ophthalmology Journal ◽

10.2174/1874364102014010082 ◽

2021 ◽

Vol 14 (1) ◽

pp. 82-87

Author(s):

Khalil M. Al-Salem ◽

Ahmad T.S. Saif ◽

Passant S. Saif

Keyword(s):

Postoperative Complications ◽

Mitomycin C ◽

Recurrence Rate ◽

University Hospital ◽

Beta Radiation ◽

Conjunctival Autograft ◽

Group A ◽

Pterygium Excision ◽

Group B ◽

Primary Pterygium

Purpose: To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft. Methods: 180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively. Results: group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation. Conclusion: Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

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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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