To compare conjunctival autografting with autologous serum against fibrin glue in pterygium excision

Background: Pterygium is a common ophthalmological problem in India. Excision of pterygium with conjunctival autograft is the main line of treatment. Many modifications of surgical techniques have been tried like conjunctival autografting with fibrin glue, sutures and autologous serum. All these modalities have their pros and cons. We compared these techniques for conjunctival autografting following pterygium surgery. Methods: A randomized interventional study was performed on 60 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a conjunctival autograft, which was fixed using autologous blood serum(in Group A, n=20), fibrin glue(in Group B, n=20) and vicryl suture (8-0) (in Group C, n=20). The patients were examined on postoperative Day 1, 1 week, 1month, 3 month and 6 month. The main outcome measures were operative time ,autograft stability, postoperative discomfort, autograft thicknes, pterygium recurrence and granuloma formation. Results: The mean operative time was significantly shorter in group A(23.60 min) followed by Group B (25.20 min) and Group C(28.15 min)(p-value <0.0001).Postoperative discomfort measured on visual analogue scale was minimal in fibrin group (p-value=0.0008) and maximum in suture group. Graft displacement was found in 2(10%) patient in autologous blood group (p value=0.349) while Graft oedema, granuloma & recurrence was noted in suture group only(p value=0.362). Conclusions: The conjunctival autografting with fibrin glue proved to be better method than autologous serum and suture, as it had very less postoperative discomfort, no recurrence, minimal edema and less graft displacement.

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Fibrin Glue Versus Autologous Serum for Conjunctival Autograft Fixation in Pterygium Surgery

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i1.1007 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Abdul Rafe ◽

Saquib Naeem ◽

Tariq Munawar

Keyword(s):

Fibrin Glue ◽

Sampling Technique ◽

Autologous Serum ◽

Bulbar Conjunctiva ◽

Dry Eyes ◽

Conjunctival Autograft ◽

Quasi Experimental ◽

Group A ◽

Pterygium Excision ◽

Group B

Purpose: To compare the outcomes of conjunctival autograft fixation using autologous serum vs fibrin glue to cover the bare sclera in pterygium excision surgery. Study Design: Quasi experimental study. Place and Duration of Study: The study was conducted in Ophthalmology Department of CMH Kharian from April 2018 to November 2018. Material and Methods: Forty patients with primary pterygium were selected by convenient sampling technique. Patients with recurrent Pterygia and moderate to severe dry eyes, keratitis or secondary to trauma were excluded. The patients were divided into two groups, group A treated with fibrin glue and group B treated with autologous serum technique. All patients underwent pterygium excision under topical anaesthesia. The conjunctival autograft was removed from superior temporal bulbar conjunctiva to cover the scleral bed produced by pterygium excision. Post operatively the patients were followed-up for three months to assess the fixation or otherwise. Data was noted and analysed by using SPSS version 23. Results: The graft was taken-up nicely in most of the cases. The patients were followed up for three months after surgery. The frequency of graft lost in Group A and Group B was noted as n = 8 (40%) and n = 1 (5%), respectively (p = 0.008). The only other complication was recurrence of pterygium which was n = 5 (25%) and n = 3 (15%), in Group A and Group B, respectively (p = 0.429). No case of infection was noted. Conclusion: Fixation of conjunctival autograft with autologous serum is a safe and effective method and potential alternative of fibrin glue technique.

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A COMPARATIVE STUDY TO EVALUATE THE OUTCOME OF SUTURES VERSUS FIBRIN GLUE IN CONJUNCTIVAL AUTOGRAFT TECHNIQUE FOR PRIMARY PTERYGIUM EXCISION

VIMS Health Science Journal ◽

10.46858/vimshsj.8105 ◽

2021 ◽

Vol 8 (1) ◽

pp. 23-27

Author(s):

Dr. Sonali Biradar ◽

Dr. Ajay Tammewar ◽

Dr. Roopa Naik

Keyword(s):

Fibrin Glue ◽

Surgical Removal ◽

Ocular Motility ◽

Significant Difference ◽

Duration Of Surgery ◽

Suture Group ◽

Pterygium Excision ◽

Conjunctival Autografting ◽

Primary Pterygium ◽

Postoperative Discomfort

Background: Pterygium is degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue and is characterized by formation of a triangular fold of conjunctiva encroaching on the cornea leading to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Now, Fibrin glue is being tried since few years to secure grafts in place of the sutures. The objective of this study was to compare duration of surgery, immediate postoperative complications which includes an inflammation, subconjunctival hemorrhage, patient comfort, graft stability between the uses of fibrin glue versus sutures. Methods: A total of 40 patients having primary pterygium were included in the study. 20 patients were underwent pterygium excision surgery and conjunctival autografting using absorbable vicryl 8-0 suture and 20 patients underwent pterygium excision surgery and conjunctival autografting using fibrin glue. These 2 groups were compared in terms of duration of the surgery, inflammation, degree of postoperative discomfort, subconjunctival haemorrhage and graft stability at postoperative day 1. Results: The mean surgery time in fibrin glue group was 15 minutes and mean surgery time in suture group was 28 minutes (p=0.000). Fibrin glue group had significantly lesser inflammation (p=0.001) as well as postoperative discomfort (p=0.000) compared to suture group at postoperative day 1. There was no significant difference found in the degree of subconjunctival haemorrhage between the fibrin glue versus sutures groups (p=0.887 and p=0.797 at day 1). The grafts secured with fibrin glue were as stable as those secured with the sutures (p=0.745, 0.644 at day 1). Conclusion: The fibrin glue group in conjuctival autografting had significantly less surgery time, which also produces significantly less postoperative discomfort as well as inflammation with grafts being as stable as those secured with sutures. Fibrin glue can be used regularly if patients can be pooled together and operated on, by making it cost effective procedure.

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The influence of pterygium morphology on fibrin glue conjunctival autografting pterygium surgery

International Ophthalmology ◽

10.1007/s10792-013-9799-2 ◽

2013 ◽

Vol 34 (1) ◽

pp. 75-79 ◽

Cited By ~ 5

Author(s):

Sekelj Sandra ◽

Janjetovic Zeljka ◽

Vukovic Arar Zeljka ◽

Samardzic Kristian ◽

Aric Ivana

Keyword(s):

Fibrin Glue ◽

Pterygium Surgery ◽

Conjunctival Autografting

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Pterygium Excision and Conjunctival Autografting without Sutures/Glue

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v7i3.137 ◽

2019 ◽

Vol 7 (3) ◽

Author(s):

Dr Battula Vishnuvardhan ◽

Keyword(s):

Pterygium Excision ◽

Conjunctival Autografting

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Postoperative treatment compliance rate and complications with two different protocols after pterygium excision and conjunctival autografting

European Journal of Ophthalmology ◽

10.1177/1120672120917335 ◽

2020 ◽

pp. 112067212091733

Author(s):

Noelia Sabater-Cruz ◽

Marina Dotti-Boada ◽

José Rios ◽

Maria Teresa Carrion ◽

Lillian Chamorro ◽

...

Keyword(s):

Postoperative Complications ◽

Ocular Hypertension ◽

Intraoperative Complications ◽

Compliance Rate ◽

Treatment Compliance ◽

Postoperative Treatment ◽

First Year ◽

Topical Steroids ◽

Pterygium Excision ◽

Conjunctival Autografting

Aim: To evaluate compliance rate to pterygium postoperative treatment with two different protocols. Methods: Review of clinical data of patients submitted to pterygium excision and conjunctival autografting in a single centre (and a single surgeon) in Barcelona between March 2014 and December 2017. Initial postoperative protocol (protocol 1) consisted of 4 months of topical steroids in a tapering fashion. Protocol 2 consisted of topical steroids tapered over 5 weeks. Compliance rate, complications and clinical outcomes were evaluated, and statistical comparisons were made. Results: 120 surgeries were performed in 99 patients. Protocol 1 was applied in 63 cases and the next 57 followed protocol 2. Compliance with protocol 1 (57.6%) was lower than with protocol 2 (84.9%) (p = 0.002). Intraoperative complications (graft tear, corneal thinning, corneal perforation and bleeding) were found in 10 cases of protocol 1 and three cases of protocol 2, p = 0.08. Postoperative complications (graft dislocation, graft haematoma, ocular hypertension and recurrence) were found in 31 cases of protocol 1 (46.2%) and eight cases of protocol 2 (14%), p = 0.001. Six weeks after surgery, ocular hypertension was detected in eight cases corresponding to protocol 1 (13.6%) and two cases of protocol 2 (3.8%), p = 0.099. Recurrence rate during first year was higher in protocol 1 (26.3%) compared to protocol 2 (7.6%), p = 0.011. No cases of visual acuity worsening or infection were registered. Conclusion: Protocol 2 has shown to have higher compliance rate than protocol 1 and less postoperative complications, proving to be a safe and effective postoperative treatment after pterygium surgery.

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