Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery

Romano, Vito; Cruciani, Mario; Conti, Luigi; Fontana, Luigi

doi:10.1002/14651858.cd011308.pub2

Cited by 52 publications

(42 citation statements)

References 68 publications

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“…However, a recently published review on the use of fibrin glue versus sutures for CAG in primary pterygium found that using fibrin glue may result in lower recurrence of pterygium. 44 Advantages of CAG over AMT are the avoidance of allograft tissue and the direct or indirect cost of surgery, including the cost of the amniotic membrane. CAG is more time-consuming than is AMT because of time spent harvesting the graft.…”

Section: Discussionmentioning

confidence: 99%

Conjunctival Autograft Versus Amniotic Membrane Transplantation for Treatment of Pterygium: Findings From a Cochrane Systematic Review

Clearfield

Hawkins

Kuo

2017

American Journal of Ophthalmology

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Purpose To summarize key findings from a systematic review of the effectiveness and risks of conjunctival autograft (CAG) compared with amniotic membrane transplant (AMT) for pterygium. Design Cochrane systematic review. Methods We included only randomized controlled trials (RCTs) in which CAG and AMT had been compared for primary or recurrent pterygia. The primary outcome was recurrence of pterygium ≥ 1 mm onto the cornea by 3 and 6 months post-surgery. We adhered to Cochrane methods for trial selection, data extraction, risk of bias evaluation, and data synthesis. Results Twenty RCTs with 1866 participants (1947 eyes) were included. Pterygium recurrence 6 months after surgery ranged from 3.3%–16.7% in the CAG group and 6.4%–42.3% in the AMT group based on data from 1021 eyes in 10 RCTs. Estimated risk ratios from meta-analysis indicated that CAG-treated eyes had a 47% lower risk of recurrence 6 months after surgery compared with the AMT group (RR, 0.53, 95% CI, 0.33 to 0.85). For 96 eyes with recurrent pterygium, the risk of recurrence 6 months after CAG was reduced by 55% compared with AMT (RR, 0.45, 95% CI, 0.21–0.99). Three-month recurrence rates were similar for CAG and AMT based on data from 538 eyes (6 RCTs). Conclusions CAG was more effective than AMT to prevent pterygium recurrence by 6 months post surgery, especially in recurrent pterygia. CAG-treated eyes had half the recurrence rates of AMT-treated eyes. Future RCTs should assess changes in patient-reported outcomes (symptoms, cosmesis) and visual acuity, and evaluate effects of surgical variations.

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Section: Discussionmentioning

confidence: 99%

Conjunctival Autograft Versus Amniotic Membrane Transplantation for Treatment of Pterygium: Findings From a Cochrane Systematic Review

Clearfield

Hawkins

Kuo

2017

American Journal of Ophthalmology

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“…Various studies and a recent meta-analysis comparing fibrin glue with sutures for fixing the conjunctival graft after primary pterygium removal was not considered in the present work because it was understood a modality of fixation of the tissue not an adjuvant therapy aimed to prevent recurrence 67. A large experience with an excision surgical technique called pterygium extended removal followed by extended conjunctival transplantation (P.E.R.F.E.C.T.)…”

Section: Discussionmentioning

confidence: 99%

Comparison among adjuvant treatments for primary pterygium: a network meta-analysis

2017

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“…Furthermore, eyes that are exposed to recurrent pterygia may have biological or environmental predisposition for profuse tissue response to the causative factors of pterygium. 6 …”

Section: Methods and Analysesmentioning

confidence: 99%

“… 11–13 Based on the recent Cochrane review, which compared fibrin glue and sutures as interventions for pterygium, higher complication rate was reported in the fibrin glue group compared with the suture group. 6 …”

Section: Introductionmentioning

confidence: 99%

Cauterisation versus fibrin glue for conjunctival autografting in primary pterygium surgery (CAGE CUP): study protocol of a randomised controlled trial

et al. 2018

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IntroductionPterygium is a non-cancerous growth of the conjunctival tissue over the cornea that may lead to visual impairment in advanced stages, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence of pterygium is a frequent problem. It has been previously shown that fibrin glue may result in less recurrence and may take less time than sutures for fixing the conjunctival graft in place during pterygium surgery. However, fibrin glue is a biological material and it carries the risk of transmitting infectious agents from pooled and single-donor blood donors and anaphylaxis in susceptible individuals. Cauterisation is another surgical option, and it would be advantageous to know whether cauterisation may be superior surgical option compared with fibrin glue. This protocol describes the rationale and design of the randomised controlled trial (RCT) in which we will compare cauterisation versus fibrin glue for conjunctival autografting in primary pterygium surgery.Methods and analysesThis will be a parallel group RCT comparing cauterisation versus fibrin glue for conjunctival autografting in primary pterygium surgery. Computer-generated randomisation will be used, and allocation concealment will be conducted using sequentially numbered opaque sealed envelopes. Surgeons will not be blinded to the procedures, but participants, other investigators and outcome assessors will be blinded. Adult participants with primary pterygium operated in a tertiary hospital in Split, Croatia, will be included. Primary outcome will be recurrence of pterygium, defined as any regrowth of tissue from the area of excision across the limbus onto the cornea after 180 days.Ethics and disseminationThe trial was approved by the ethics review board of the University Hospital Split (500-03/17-01/68). Results will be disseminated at conferences and through peer-reviewed publications.Trial registration numberNCT03321201; Pre-results.

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Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery

Cited by 52 publications

References 68 publications

Conjunctival Autograft Versus Amniotic Membrane Transplantation for Treatment of Pterygium: Findings From a Cochrane Systematic Review

Conjunctival Autograft Versus Amniotic Membrane Transplantation for Treatment of Pterygium: Findings From a Cochrane Systematic Review

Comparison among adjuvant treatments for primary pterygium: a network meta-analysis

Cauterisation versus fibrin glue for conjunctival autografting in primary pterygium surgery (CAGE CUP): study protocol of a randomised controlled trial

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