Fibrin glue versus vicryl sutures for primary conjunctival closure in pterygium surgery: long-term results.
OBJECTIVE
To compare the long-term results of conjunctival closure with fibrin adhesive or Vicryl sutures in pterygium surgery.


METHODS
The study was performed in 81 patients (81 eyes) with primary nasal pterygium. Surgery in all patients consisted of the bare sclera technique combined with intraoperative administration of mitomycin C 0.02%. Patients were randomized to undergo conjunctival closure with a fibrin adhesive (Quixil) (n = 42) or Vicryl sutures (n = 39). Clinical assessment was performed on postoperative days 1, 3, 10, and 21 and thereafter at 3, 6, and 12 months. All patients completed a questionnaire at each follow-up visit grading pain, discomfort, and satisfaction with the procedure. The groups were compared for operative time, ocular signs and symptoms, overall satisfaction, and recurrence rate.


RESULTS
Average operative time was 16 min in the fibrin-glue group and 28 minutes in the Vicryl-suture group (p < 0.05). Significantly less pain and discomfort were noted in the subjects treated with glue than in controls (p < 0.05). Satisfaction was significantly higher in the study group (p < 0.04). There were no complications during follow-up period in the glue-treated patients; one patient in the suture group had a medically treatable corneal dellen. At the end of follow-up, recurrent pterygium developed in five (11.9%) eyes of the fibrin-glue group and in three (7.7%) eyes of the Vicryl-suture group (p < 0.05).


CONCLUSIONS
The use of fibrin glue in pterygium surgery significantly reduces operative time and patient pain compared with suturing. However, it may be associated with a higher recurrence rate.
Bahar
Irit
I
Department of Ophthalmology and External Eye Disease Clinic, Rabin Medical Center, Beilinson Campus, Petah-Tiqwa 49 100, Israel. iritbahar@yahoo.com
Weinberger
Dov
D
Gaton
Dan D
DD
Avisar
Rahamim
R
D000328:Adult; D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D017060:Patient Satisfaction; D011098:Polyglactin 910; D011446:Prospective Studies; D011625:Pterygium / Q000601:surgery*; D012008:Recurrence; D011795:Surveys and Questionnaires; D013537:Sutures
D015718:Fibrin Tissue Adhesive; D011098:Polyglactin 910