title: The influence of pterygium morphology on fibrin glue conjunctival autografting pterygium surgery.
abstract: To evaluate the influence of pterygium morphology on the efficacy and safety of fibrin glue in pterygium surgery with conjunctival autografting. A prospective case series. During a period of 15 months, 45 patients (51 eyes) were recruited from the General Hospital for pterygium surgery. Seven eyes (13.73 %) were operated on for a recurrent pterygium. Autologous conjunctiva was harvested from the superior bulbar conjunctiva and fixed with fibrin glue. The pterygia were preoperatively divided into atrophic/grade 1 (n = 18; 35.29 %), intermediate/grade 2 (n = 22; 43.14 %) or fleshy/grade 3 (n = 11; 21.57 %) according to clinical morphology. Patients were evaluated for intraoperative and postoperative complications and recurrence rates. The success rate was defined by no pterygium recurrences. Patients with 2-year follow-ups were included in this study. Fifty-one patients (21 females/30 males) with a mean age of 60-65 years (range 24-87 years) took part in the study. All patients completed the study. No intraoperative complications were noted. Postsurgical complications included graft edema (n = 4; 7.8 %), graft hyperemia (n = 2; 3.8 %), and graft dislocation (n = 3; 5.9 %); these complications were transient. One graft unfastened completely (2 %) and five pterygium recurrences occurred (n = 5; 9.8 %). The overall success rate was 90 % after 2 years. In grade I group there were no recurrences, in grade 2 group there were two recurrences, and in grade 3 group there were three recurrences. There were significantly more recurrences in grade 3 group than in grade 2 group. There were more recurrences in both groups than in group 1 (60 vs 40 vs 0 % of all recurrences, p ≤ 0.05). The use of fibrin glue is a safe, easy and effective technique for attaching the conjunctival autograft in pterygium surgery. The morphology of pterygium influences recurrence rates, without significance for intraoperative and postoperative complications.
authors.affiliation: Department of Ophthalmology, General Hospital Dr. J. Bencevic, KS Djalskog 2, 35000, Slavonski Brod, Croatia, sandra.sekelj@yahoo.com.
authors.forename: Sekelj
authors.initials: S
authors.lastname: Sandra
authors.forename: Janjetovic
authors.initials: J
authors.lastname: Zeljka
authors.forename: Vukovic Arar
authors.initials: VA
authors.lastname: Zeljka
authors.forename: Samardzic
authors.initials: S
authors.lastname: Kristian
authors.forename: Aric
authors.initials: A
authors.lastname: Ivana
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects / Q000592:standards*; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011625:Pterygium / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive