Surgery of the pterygium with fibrin glue: A clinical study in Nigeria

Abstract

Aims: To assess (i) the efficacy of conjunctival autograft with fibrin glue in the management of pterygium, (ii) graft-related complications and (iii) recurrence rates over a 6-month follow-up period. Settings and Design: The study was conducted at the Orbit Thelish Eye Hospital in joint association with Dr. Agarwal Eye Hospital, Kaduna, Nigeria. This prospective study included 30 consecutive patients who underwent surgery of the pterygium using conjunctival autograft with fibrin glue by a single surgeon between August 2015 and July 2016. Inclusion criteria were primary pterygium and recurrent pterygium. Exclusion criteria were pseudopterygium, moderate-to-severe dry eye and patients with lid deformity. Materials and Methods: A total of 30 eyes with primary nasal pterygium were subjected to conjunctival autograft surgery that used fibrin glue. The outcome of surgery was noted on the 1st day, 1st week, 1st month, 3rd month and 6th month. Parameters analysed were subjective symptoms, refraction, graft status and recurrence. Statistical analysis used included the following: Student t-test and Fisher’s exact test. Results: The mean age of the patients was 43.7 years. The time of surgery was 15–20 min. During the postoperative course, 60% of the patients felt pain initialy and 25% had an initial sensation of a mild foreign body, which almost subsided in 1 week. No sutures were used. Only one case of pterygium regrowth was noted. Conclusion: Our findings demonstrate the safety and efficacy of Tissucol Duo® (Baxter AG, Vienna, Austria) as a conjunctival adhesive for autograft surgery of the pterygium. Because of its fast and easy application, this product considerably reduces the time of surgery and avoids complications derived from sutures in the eye following surgery.