Randomized interventional trial comparing conjunctival autograft secured with Sutures versus fibrin glue in primary pterygium excision

Keerthivarman Rukmangathan, Dhivya Ramakrishnan, Vasudarini Sundararajan, Ranjan Chandrasekaran, Ramusiddharthan Ravichandran, Shankar Radhakrishnan


Background: An ideal pterygium surgery should achieve three principal goals: a low recurrence rate, absence of complications, and satisfactory cosmesis. Natural substances, such as fibrin, have significant advantage in achieving these goals. Aim: To compare the primary & secondary outcomes following primary pterygium excision with conjunctival auto graft using fibrin glue versus sutures. Methodology: A prospective interventional study was conducted at Department of Ophthalmology, Annapoorana medical college& Hospital, Salem, India, for a period of one year from June 2016 to May 2017. A total of 87 patients were included in the study. They were randomized into two groups. Group I received conjunctival auto graft secured with glue and Group II received conjunctival auto graft secured with suture. Postoperatively the patients were followed for a period of 6 months for measuring the primary and secondary outcomes.  Results: The mean rank score for graft inflammation, and patients discomfort was less in fibrin glue group when compared to suture group during the follow-up period from 15th to 90th postoperative day and the difference was found to be statistically significant, whereas the mean rank for graft stability was lower in the suture group when compared to the fibrin glue group with a statistical significant difference between the two group. Conclusion: 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.

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