Evicel versus Tisseel versus Sutures for Attaching Conjunctival Autograft in Pterygium Surgery

Zloto, Ofira; Greenbaum, Eran; Fabian, Ido Didi; Simon, Guy J. Ben

doi:10.1016/j.ophtha.2016.09.010

Cited by 23 publications

(28 citation statements)

References 19 publications

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“…Previous reported recurrence rate was 3.3-18.5% for experienced surgeons 6 , and 10-82% for trainees 8,15 . The lower recurrence rate in this study can be attributed to two reasons: CAG transplantation has been shown to be superior to bare sclera technique or AMT 4,9,10 , with respect to recurrence, and in all cases we used fibrin glue, which is associated with lower recurrence compared to sutures 38 .…”

Section: Discussionmentioning

confidence: 73%

Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

Liu

Tan

et al. 2020

Sci Rep

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Femtosecond laser-assisted conjunctival autografts (CAG) preparation was recently proposed. This study reports the outcomes of the first clinical trial on the use of laser to prepare CAG in pterygium surgery, and to compare the outcomes with those of manual technique. Forty eyes undergoing primary pterygium excision with laser-assisted CAG transplantation were prospectively included (L group). Two historical matched cohorts whose cAGs were prepared manually were compared (n = 78 eyes by the same experienced surgeon, M group; n = 78 eyes by trainees; TM group). We found the laser-created CAGs had only 11 μm deviation from the targeted thickness. The best-corrected visual acuity improved, and the astigmatism significantly decreased after surgery, with comparable efficacy across 3 groups. The 1-year recurrence rate was 2.5%, 3.8% and 7.7% in the L, M and TM groups, respectively (P = 0.12). There was no significant difference between the L and M groups in the complication rate (5.0% and 1.3%, respectively), surgical time (19.4 ± 5.1 and 19.1 ± 6.2 minutes, respectively), and postoperative discomfort scores (0.1 ± 0.3 and 0.2 ± 0.3, respectively), but these outcomes were significantly less favorable in the TM group. The results of this first comparative clinical trial suggest that femtosecond laser-assisted CAG preparation can be considered as an alternative technique for CAGs preparation.

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Section: Discussionmentioning

confidence: 73%

Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

Liu

Tan

et al. 2020

Sci Rep

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“…In a study by zloto et al, the recurrence rate was 17.24 in the suture group whereas in our study the recurrence rate was 2.89%. [ 18 ] Conjunctival edema was seen in 122 (70.52%) in Group 1, 151 (43.02%) in Group 2, and 139 (88.54%) in Group 3. Granuloma formation was seen in 2 (1.16%) in Group 1, no patients in Group 2, and 1 (0.64%) in Group 3.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of pterygium surgery-glue versus autologous blood versus sutures for graft fixation-an analysis

Kodavoor¹,

Dandapani²,

Solomon³

2018

Oman J Ophthalmol

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AIM:The aim of this study is to compare the surgical outcomes of pterygium excision with conjunctival autograft using sutures, fibrin glue (tisseel), and autologous blood for the management of primary pterygium.PATIENTS AND METHODS:A retrospective study done in 681 eyes with primary nasal pterygium. Excision of the pterygium was performed followed by closure of the bare sclera with conjunctival autograft using interrupted 10-0 monofilament nylon sutures in 173 eyes (Group 1), fibrin glue (tisseel-baxter healthcare corporation, westlake village, ca-91362 USA) in 351 eyes (Group 2), and autologous blood in 157 eyes (Group 3). Patients were followed up for a period of 5–52 months. During follow-up, graft-related complications such as recurrence, graft loss, graft retraction, granuloma if any were noted and compared among the three groups.RESULTS:A total of 681 eyes who had primary nasal pterygium were included in this study. Pterygium excision with conjunctival autograft was performed using 10-0 monofilament nylon interrupted sutures in 173 eyes (25.4%), tisseel fibrin glue in 351 eyes (51.54%), and autologous blood in 157 (23.05%) eyes. The mean duration of follow-up was 5–52 months. The overall recurrence rate was 2.9% (20 eyes). In Group 1, recurrence was seen in 5 eyes (2.89%), in Group 2, it was seen in 7 eyes (1.99%) and in Group 3, 8 eyes (5.10%). However, the recurrence rate was not significant (P = 0.160). The rate of graft retraction in the 3 study groups were 12 eyes (6.94%), 10 eyes (2.85%), and 56 eyes (35.67%) with a significant P < 0.001. Granuloma was seen in 2 eyes (1.16%), in Group 1, and in 1 eye (0.64%) in Group 3. Graft loss was seen in 3 eyes (1.73%), 4 eyes (1.14%), 6 eyes (3.82%) in Group 1, 2, and 3, respectively.CONCLUSION:The outcomes of the three most commonly performed surgical technique of conjunctival autograft fixation has shown us that all three techniques are equally comparable and can be offered to our patients with equally good results.

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“…Surgical techniques have evolved from bare sclera technique, autorotation of conjunctival graft, use of amniotic membrane graft to the development of conjunctivo-limbal autograft 4,5,6 . One of the popular techniques used is excision of pterygium is covering the defect with conjunctival autograft, which is either sutured or fixed with fibrin glue 7 . Fixing the graft with fibrin glue reduces operative time, gives good cosmetic results and causes less post operative discomfort however like any other surgical procedure it has some disadvantages like increased cost, graft loss, granuloma formation and transmission of infection to mention a few.…”

Section: Introductionmentioning

confidence: 99%

Fibrin Glue Versus Autologous Serum for Conjunctival Autograft Fixation in Pterygium Surgery

2020

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Purpose: To compare the outcomes of conjunctival autograft fixation using autologous serum vs fibrin glue to cover the bare sclera in pterygium excision surgery. Study Design: Quasi experimental study. Place and Duration of Study: The study was conducted in Ophthalmology Department of CMH Kharian from April 2018 to November 2018. Material and Methods: Forty patients with primary pterygium were selected by convenient sampling technique. Patients with recurrent Pterygia and moderate to severe dry eyes, keratitis or secondary to trauma were excluded. The patients were divided into two groups, group A treated with fibrin glue and group B treated with autologous serum technique. All patients underwent pterygium excision under topical anaesthesia. The conjunctival autograft was removed from superior temporal bulbar conjunctiva to cover the scleral bed produced by pterygium excision. Post operatively the patients were followed-up for three months to assess the fixation or otherwise. Data was noted and analysed by using SPSS version 23. Results: The graft was taken-up nicely in most of the cases. The patients were followed up for three months after surgery. The frequency of graft lost in Group A and Group B was noted as n = 8 (40%) and n = 1 (5%), respectively (p = 0.008). The only other complication was recurrence of pterygium which was n = 5 (25%) and n = 3 (15%), in Group A and Group B, respectively (p = 0.429). No case of infection was noted. Conclusion: Fixation of conjunctival autograft with autologous serum is a safe and effective method and potential alternative of fibrin glue technique.

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Evicel versus Tisseel versus Sutures for Attaching Conjunctival Autograft in Pterygium Surgery

Cited by 23 publications

References 19 publications

Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

Outcomes of pterygium surgery-glue versus autologous blood versus sutures for graft fixation-an analysis

Fibrin Glue Versus Autologous Serum for Conjunctival Autograft Fixation in Pterygium Surgery

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