Background: Pterygium is degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue and is characterized by formation of a triangular fold of conjunctiva encroaching on the cornea leading to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Now, Fibrin glue is being tried since few years to secure grafts in place of the sutures. The objective of this study was to compare duration of surgery, immediate postoperative complications which includes an inflammation, subconjunctival hemorrhage, patient comfort, graft stability between the uses of fibrin glue versus sutures. Methods: A total of 40 patients having primary pterygium were included in the study. 20 patients were underwent pterygium excision surgery and conjunctival autografting using absorbable vicryl 8-0 suture and 20 patients underwent pterygium excision surgery and conjunctival autografting using fibrin glue. These 2 groups were compared in terms of duration of the surgery, inflammation, degree of postoperative discomfort, subconjunctival haemorrhage and graft stability at postoperative day 1. Results: The mean surgery time in fibrin glue group was 15 minutes and mean surgery time in suture group was 28 minutes (p=0.000). Fibrin glue group had significantly lesser inflammation (p=0.001) as well as postoperative discomfort (p=0.000) compared to suture group at postoperative day 1. There was no significant difference found in the degree of subconjunctival haemorrhage between the fibrin glue versus sutures groups (p=0.887 and p=0.797 at day 1). The grafts secured with fibrin glue were as stable as those secured with the sutures (p=0.745, 0.644 at day 1). Conclusion: The fibrin glue group in conjuctival autografting had significantly less surgery time, which also produces significantly less postoperative discomfort as well as inflammation with grafts being as stable as those secured with sutures. Fibrin glue can be used regularly if patients can be pooled together and operated on, by making it cost effective procedure.
Duke-Elder S. Diseases of the outer eye. In : System of Ophthalmology, volume 8, St. Louis: CV Mosby; 1965.
Gurinder Singh. Pterygium and its surgery.In: Foster CS, Azar DT, Dehlman CH. Smolin and Thoft?s The Cornea scientific foundations and clinical practice, 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2005.
Coster D. Pterygium - an ophthalmic enigma.Br J Ophthalmol 1995; 79(4) : 304-305.
Sihota R, Tandon R. Diseases of the conjunctiva. In: Parson's Diseases of the Eye. 21st ed. New Delhi : Elsevier; 2011. Jun;29(5):552-558.
Tan D , Chan C. Management of pterygium. In ;Krachmer JH, Mannis MJ, Holland EJ. Cornea – Fundamental diagnosis and management, 3rd ed.Philadelphia: Mosby Elsevier;2011.
Karalezli A, Kucukerdonmez C, Akova YA, Altan-Yaycioglu R, Borazan M. Fibrin glue versus sutures for conjunctival autografting in pterygium surgery: a prospective comparative study. Br J Ophthalmol. 2008 Sep;92(9):1206- 1210.
Farjo QA, Sugar A.Pterygium and conjunctival degenerations. In :Yanoff M, Duker JS.Ophthalmology, 3 rd ed. Philadelphia : Mosby Elsevier;2009.
Srinivasan S, Dollin M, McAllum P, Berger Y, Rootman DS, Slomovic AR. Fibrin glue versus sutures for attaching the conjunctival autograft in pterygium surgery: a prospective observer masked clinical trial. Br J Ophthalmol. 2009Feb;93(2):215-218.
Koranyi G, Seregard S, Kopp ED. Cut and paste: a no suture, small incision approach to pterygium surgery. Br J Ophthalmol. 2004 Jul;88(7):911-914.
Uy HS, Reyes JMG, Flores JDG, Lim-Bon-Siong R. Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision. Ophthalmology 2005 April;112(4):667-671.
Ozdamar Y, Mutevelli S, Han U, Ileri D, Onal B, Ilhan O, et al. A comparative study of tissue glue and vicryl suture for closing limbal-conjunctival autografts and histologic evaluation after pterygium excision. Cornea. 2008 Jun;27(5):552-558.
Arora R, Goyal JL, Kang J,Seetaram S. Fibrin glue versus vicryl suture in limbo Conjunctival autograft in the management of primary pterygium: A prospective Comparative study.In: Bhattacharya D, editor.All India Ophthalmological Conference proceedings 2010; 2010 Jan 21-24; Kolkata, India. 2010: p 263-265. 60) Cha DM, Kim KH, Choi HJ, Kim MK, Wee WR. A
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