Comparison of fibrin glue with sutures for pterygium excision surgery with conjunctival autografts.
OBJECTIVE
To compare pterygium excision conjunctival autograft surgery using Tisseel fibrin glue versus Vicryl sutures.


METHODS
Prospective randomized clinical trial. Fifty patients were randomized into either sutured graft or glued graft groups. Twenty-five received standard conjunctival autograft sutured with Vicryl and 25 received surgery with the autograft placed with Tisseel fibrin glue. Outcome measures include surgical time, patient discomfort, pathology, complications and recurrence rates at 3, 6 and 12 months. Patients were followed up at days 1, 7, 14, 30, 90, 180 and 365.


RESULTS
The mean surgical time for the glue group was significantly shorter at 12 min compared with the suture group at 26 min (P < 0.001). Postoperative pain was significantly less at day 1 (P < 0.001) and day 2 (P < 0.05) but was not significantly different following these visits. Complications in the glue group included one patient with an absent graft at week 1 that required revision of the graft. At 3 months there were no recurrences in the glue group and two recurrences in the suture group. The 6- and 12-month recurrence rate was unchanged and not significantly different between the glue and suture groups (both 0/24 and 2/23, respectively).


CONCLUSIONS
Both glued and sutured conjunctival autografting procedures are safe and effective methods for pterygium surgery. The glued autograft recurrence rate at 12 months was similar to that of sutured grafts. Conjunctival autograft with fibrin glue in pterygium surgery decreased surgical time and resulted in less postoperative pain in the first 48 hours but had a higher complication rate.
Hall
Reece C
RC
Ophthalmology Department, Wellington Hospital, Capital Coast District Health Board, Wellington, New Zealand. reecechall@gmail.com
Logan
Andrew J
AJ
Wells
Anthony P
AP
D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011098:Polyglactin 910; D011183:Postoperative Complications; D011625:Pterygium / Q000601:surgery*; D012008:Recurrence; D013536:Suture Techniques; D013537:Sutures; D013997:Time Factors; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D011098:Polyglactin 910