title: Superior versus inferior conjunctival autografts combined with fibrin glue in the management of primary pterygia.
abstract: OBJECTIVE
  To compare the outcomes of superior versus inferior conjunctival autograft (CAU) in the prevention of recurrence after performing a pterygium surgery in patients with primary pterygia.
  
  
  METHODS
  This was a prospective randomized study of 60 eyes of 60 patients with primary pterygium. All the eyes underwent pterygium excision and were assigned randomly to receive either superior (30 eyes) or inferior (30 eyes) CAU. All grafts were attached with fibrin glue. The patients were followed up on postoperative day 1, day 7, 1 month, 3 months, and 6 months.
  
  
  RESULTS
  Outcome measures included rate of recurrence, mean surgical time, visual analog scale pain score, and amount of pain medication required in the first postoperative week. The mean surgical time, visual analog scale pain score, and amount of pain medication required in both groups were not statistically different. A follow-up of at least 6 months (mean 5.5 ± 1.1 months) was achieved in 49 eyes of 49 patients (24 eyes in the superior CAU group and 25 eyes in the inferior CAU group). One eye in the superior CAU group (4.2%) and 1 eye in the inferior CAU group (4.0%) developed pterygium recurrence. There was no statistically significant difference in the recurrence rates between the 2 groups. In the inferior CAU group, mild localized donor site scarring was noted in 2 patients (8.3%).
  
  
  CONCLUSIONS
  Pterygium excision with superior or inferior CAU secured with fibrin glue is safe and effective. There was no significant difference in surgical time, pain, and recurrence rates of pterygium after excision with superior or inferior CAU.
authors.affiliation: *Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, ON; and †Department of Ophthalmology, University of British Columbia, Vancouver, BC.
authors.forename: Sonia N
authors.initials: SN
authors.lastname: Yeung
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lichtinger
authors.forename: Peter
authors.initials: P
authors.lastname: Kim
authors.forename: Uri
authors.initials: U
authors.lastname: Elbaz
authors.forename: Judy Y F
authors.initials: JY
authors.lastname: Ku
authors.forename: Maoz D
authors.initials: MD
authors.lastname: Amiran
authors.forename: Nathan
authors.initials: N
authors.lastname: Gorfinkle
authors.forename: Rachel
authors.initials: R
authors.lastname: Wolff
authors.forename: Allan R
authors.initials: AR
authors.lastname: Slomovic
mesh_terms: D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D011625:Pterygium / Q000517:prevention & control / Q000601:surgery*; D055502:Secondary Prevention; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014182:Transplantation, Autologous
chemical_list: D018712:Analgesics, Non-Narcotic; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives