Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial

Abstract

Purpose To compare the results of amniotic membrane transplantation (AMT) using fibrin glue vs vicryl sutures in pterygium surgery. Methods We carried out a prospective, randomised clinical study of 70 eyes (70 patients) with primary pterygium. After the removal of pterygium, patients were randomised to undergo AMT using fibrin glue (Tisseel, 32 eyes) or 8-0 vicryl sutures (38 eyes). Clinical examination and digital photographing were performed at each visit and the patients were followed up for at least 12 months. Post-operative symptoms in the first month were evaluated according to a fivepoint scale. Final appearances were graded from 1 to 4 in which grade 4 represented true (corneal) recurrence and grade 3 indicated conjunctival recurrence. Results The average operation time in the fibrin glue and suture groups were 11.2 ± 2.4 min (mean ± SD) and 18.7 ± 2.2 min, respectively (P ¼ 0.018). Significantly fewer post-operative symptoms were observed in the fibrin glue group at post-operative days 1, 7, and 14 (Po0.05 for all). At the end of the follow-up, true recurrence (grade 4) was developed in three eyes (9.4%) in the fibrin glue group, and in four eyes (10.5%) in the suture group (P ¼ 0.33). The rates of conjunctival recurrence (grade 3) were 21.9% (seven eyes) and 23.7% (nine eyes) in the fibrin glue and suture groups, respectively (P ¼ 0.38). Conclusions Amniotic membrane grafts can be successfully attached without any major complication in patients undergoing pterygium surgery. In addition, it is effective in shortening the duration of surgery and preventing post-operative discomfort. Although there seems to be no difference in the recurrence rates and cosmetic outcomes between both groups, neither technique represents best results.

Astigmatic changes following pterygium removal: Comparison of 5 different methods

“…On the other hand, in the AMT-g group, fibrin glue was used to attach the amniotic membrane as reported earlier. [8]…”

The Variation in Surgical Technique and Role of Physician Experience in Pterygium Surgical Outcomes

“…Many studies have found lower recurrence rates and faster operation times associated with fibrin glue use [29,[49][50][51][52][53][54]. Our study population had only 18 cases using fibrin glue, and the recurrence rate was not statistically different from sutures (p=0.126, Fisher exact).…”

Oral Mucosal Grafts in Severe Pterygium: Case Report

“…Tek başına amniyotik membran transplantasyonu kullanılan hastalarda nüks oranı oldukça değişiklik göstermektedir. 27,28 Amniyon membranı antiinflamatuar, antianjiyogenik ve antiproteolitik aktivitesi sayesinde ekstraselüler matriks üretimi ve skar oluşumunun önüne geçebilmektedir. 29 Amniyon membranı aynı zamanda konjonktiva epitel hücre- lerinin büyümesi ve farklılaşması için gerekli substratları da barındırmaktadır.…”