The cut‐and‐paste method for primary pterygium surgery: long‐term follow‐up

Abstract

ABSTRACT.Objective: To evaluate the recurrence rate, reoperation rate and side-effects of a novel technique for pterygium surgery. Design: Retrospective study. Participants: The study included 461 eyes of 381 patients operated for primary nasal pterygium by the same surgeon between 1994 and 2003 and followed for 23 ± 20 months (range 6-112 months). Methods: Autologous conjunctival grafts harvested at the superotemporal limbus were used to cover the sclera after pterygium excision. Using a retrospective chart review, the outcome after attaching the transplant to the sclera with a fibrin tissue adhesive (n = 325) was compared to the outcome after graft attachment using absorbable sutures (n = 136). Main outcome measures: Recurrence rate, reoperation rate and complications. Results: The recurrence rate was 5.3% in the glue group and 13.5% in the suture group (p = 0.01). The reoperation rates were 1.2% and 3.3%, respectively (p = 0.31). Complications, such as transient transplant oedema and persistent corneal epithelial defects, occurred equally in both groups. Conclusion: Using a fibrin tissue adhesive instead of sutures when attaching the conjunctival transplant in primary pterygium surgery results in a significantly lower recurrence rate.

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

“…This effort to mask the patients was also performed in earlier studies. [5][6][7][8] When fibrin glue is used, the retraction of the host conjunctiva or graft may result in gap formation between the graft in the early post-operative period. It is suggested that rapid epithelisation of the amniotic membrane prevents post-operative inflammation and thereby reduces the recurrence rate.…”

“…These findings were also consistent with the studies of CA using fibrin glue, in which a number of different symptom scales have been used. [4][5][6][7][8] Shortening the surgery time and improving post-operative comfort may have several advantages. First, the use of fibrin glue removes the need for the tedious suturing process, the learning curve can be shortened, and better results may be more consistently achieved despite differences in surgical expertise.…”

“…The sample size in this study was calculated based on the recurrence rates in the study of Koranyi et al, 5 which used the same type of fibrin glue (Tisseel) and sutures (Vicryl, Johnson&Johnson, Somerville, NJ, USA).…”

“…[4][5][6][7][8] In addition, the outcomes of AMT using fibrin glue for corneal ulceration, perforation, and ocular surface reconstruction have been reported in clinical and experimental studies. [9][10][11][12][13] However, the results of pterygium surgery with AMT using fibrin tissue sealants have been evaluated in limited number of studies.…”

Tissue adhesives in ocular surgery

“…Reduced recurrence rate has also been reported for conjunctival autografting in pterygium surgery with the use of fibrin glue compared with sutures. Koranyi et al postulate that fibrin glue facilitates better adhesion of the graft with the underlying tissues, which may result in early graft vascularization and thus prevents recurrence [63]. The success of autografts may also be affected by conjunctival inflammation.…”