Fibrin Glue-Assisted Conjunctival Autografting in Pterygium Surgery

Abstract

Objective: To evaluate the feasibility of applying fibrin glue (FG) in pterygium excision surgery with conjunctival autografts (CAG). Design: Prospective non-comparative case series Methods: Twenty patients with primary or recurrent pterygium. Patients were divided into two groups: group 1 consisted of 13 eyes (13 patients) with primary pterygium; group 2 had 7 eyes (7 patients) with recurrent pterygium. All patients in group 2 received additional intraoperative 0.02% mitomycin C on the pterygium-removed bare sclera for 3 minutes prior to CAG. FG was applied to replace sutures for graft fixation in all cases. Main outcome measures include levels of patient's discomfort, operation time, and pterygium recurrence rate. Results: Mean age of overall patients was 62.2±11.6 years old (range, 36-80 years old). Postoperative follow-up period ranges from 7 to 20 months (mean±SD, 12.9±3.5 months). Mean operation time was 16.7±4.0 minutes and 24.5±3.7 minutes in group 1 and 2, respectively. Minimal post-op discomfort was noted in both group 1 and group 2 with no significant difference. The postoperative pain score was 0.9±0.5 and 1.3±0.8 on Day 1, 0.0±0.0 and 0.2±0.4 at one week in group 1 and 2, respectively. By the end of study, recurrence of pterygium was found only in a single case in group 1 and none in group 2, with an overall recurrence rate of 5.0%. Conclusion: FG-assisted CAG in pterygium surgery significantly shortened operation time, alleviated postoperative discomfort and reduced disease recurrence. However, a comparative study and longer follow-up are needed to validate its effect in reducing pterygium recurrence.