Comparison of Fibrin Glue and Autologous Blood for Conjunctival Autograft Fixation in Pterygium Surgery
Narrative Responses:
Purpose
The purpose of this study is to compare the outcomes between autologous blood and fibrin glue fixated conjunctival autograft techniques for pterygium excision surgery.
Methods
This is a retrospective comparative case series of 40 patients who had a primary nasal pterygium excised. All patients had a conjunctival autograft from the superior bulbar conjunctiva to cover the scleral bed. Twenty patients had fixation of the autograft using autologous blood (AB) and 20 patients had fixation using fibrin glue (FG). One year of follow-up data included: conjunctival graft stability (graft loss, graft displacement), pterygium recurrence, visual acuity, surgical cost, and surgical time. Descriptive and inferential statistics were performed.
Results
Intraoperatively, no complications occurred in either group. Within the first day after surgery, 6 patients in the AB group lost their graft compared to none in the FG group. Mild graft displacement was seen in 3 patients in AB group and 2 patients in the FG group. At 1 year post-operatively, pterygium recurrence occurred in 5 patients in the AB group and 1 patient in the FG group. Surgical costs differed between groups. The FG group incurred the cost of additional materials (fibrin glue), whereas the AB group had costs associated with an extra 15 minutes of procedure time.
Conclusion
Conjunctival autograft fixation with autologous blood resulted in less stable conjunctival autografts, more pterygium recurrences, similar vision, and increased procedure time compared to fixation with fibrin glue.