Biological glue in pterygium surgery with a rotational flap or sliding flaps.
OBJECTIVE
To compare 2 surgical approaches to conjunctival flap placement during pterygium surgery using a biologic adhesive: single rotational flap and double sliding flaps.


METHODS
Thirty-three consecutive patients (34 eyes) with primary pterygium were assigned prospectively and randomly to receive pterygium surgery with either 1 rotational flap (group A, 19 eyes) or double sliding flaps (group B, 15 eyes) by using a biologic adhesive to secure the flaps. The patients were followed for 24 weeks.


RESULTS
In group A, 1 (5.3%) flap was lost because of ischemia, whereas all the others remained in position and became fully integrated. In group B, 4 (26%) flaps did not retain their primary position. In 2 (13%) eyes, the superior and inferior flaps partially dehisced, resulting in a 2- to 3-mm gap; in 1 (6.5%) eye, the inferior flap dehisced completely and retracted to the lower fornix; and in 1 (6.5%) eye, both flaps completely dehisced and retracted, leaving an area of bare sclera.


CONCLUSIONS
The use of tissue adhesive is a promising technique in pterygium surgery. In this study, gluing 1 rotational flap resulted in excellent postoperative results, but it seemed less suitable for use with double sliding flaps.
Benyamini
Oren G
OG
Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel.
Barkana
Yaniv
Y
Hartstein
Morris
M
Attas
Liat
L
Avni
Isaac
I
Zadok
David
D
D000328:Adult; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives