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Fibrin Adhesive Is Better Than Sutures in Pterygium Surgery

Ratnalingam, Vanitha MSurg (Ophthal); Keat Eu, Andrew Lim MMed (Ophthal); Ng, Gim Leong MMed (Ophthal); Taharin, Rohana MSurg (Ophthal); John, Elizabeth DO

doi: 10.1097/ICO.0b013e3181c29696
Clinical Science

Purpose: To evaluate the recurrence rate, surgical time, and postoperative pain between conjunctival autografting with sutures and with fibrin adhesive in pterygium surgery.

Methods: A prospective, randomized, double-blind, clinical trial on the benefits of using fibrin adhesive in place of sutures in pterygium surgery. One hundred seventy-five eyes with primary pterygium were randomized to undergo pterygium surgery with conjunctival autograft transplantation using either fibrin adhesive or sutures. One hundred thirty-seven eyes of 113 patients that were operated on by a single surgeon (V.R.) completed the 1-year follow-up. Sixty-eight eyes were operated with fibrin adhesive and 69 eyes with sutures. Patients were followed up at 1 day, 1 week, 1 month, 6 months, and 1 year after surgery. Pterygium recurrence and postoperative pain was graded by an independent observer (A.L.) masked to the method of treatment. Surgical time was measured with a stopwatch.

Results: All patients were followed up for 1 year. There were 3 recurrences (4.41%) in the fibrin adhesive group and 11 recurrences (15.9%) in the suture group. The mean duration required to complete surgery in the fibrin adhesive group was 16.93 ± 2.85 minutes, whereas that of the suture group was 29.84 ± 5.65 minutes, which was statistically significant (P < 0.001). The immediate postoperative pain score and week 1 postoperative pain score were significantly lower in the fibrin adhesive group (P < 0.05). No major complications were observed in either group.

Conclusion: The use of fibrin adhesive in primary pterygium surgery with conjunctival autografts reduces the recurrence rate, surgical time, and postoperative pain when compared with sutures.

From the Ophthalmology Department, Penang Hospital, Penang, Malaysia.

Received for publication April 21, 2009; revision received August 3, 2009; accepted August 17, 2009.

Reprints: Dr. Vanitha Ratnalingam, RE 12A-13, The Ophthalmology Department, Sarawalk General Hospital, Kuching, Sarawak (e-mail: v_ratnalingam@yahoo.com).

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