Presentation on theme: "J.Talajic, K. Miszkiewicz, L. Racine, M. Harissi-Dagher The authors have no financial interest in the subject matter of this poster. Fibrin Glue versus."— Presentation transcript:
J.Talajic, K. Miszkiewicz, L. Racine, M. Harissi-Dagher The authors have no financial interest in the subject matter of this poster. Fibrin Glue versus Nylon Sutures for Conjunctival Autografting in Pterygium Surgery
2 BACKGROUND Conjunctival autografting after pterygium excision is associated with very low rates of recurrence. Disadvantages of graft suturing include: longer surgery duration (vs. bare sclera technique), potential for granuloma formation and giant papillary conjunctivitis, and patient discomfort. Fibrin-based adhesives for the attachment of conjunctival grafts have been associated with shorter surgery duration, improved patient comfort, and fewer complications. However, the recurrence rates with the use of fibrin glue have been investigated in few studies, the results of which have been inconsistent.
PURPOSE To determine the safety and efficacy of using fibrin glue (Tisseel VH, Baxter) to attach conjunctival autografts To compare the results with the use of nylon sutures in patients undergoing primary pterygium excision
STUDY DESIGN A retrospective case series was conducted of 23 eyes (23 patients) who underwent primary pterygium excision with conjunctival autograft between 2007 and 2009 at CHUM Hôpital Notre Dame in Montreal, Canada. Patients with autoimmune disease, a history of previous ocular surgery or trauma, and those who received intraoperative Mitomycin C were excluded from this study.
METHODS Of the 23 eyes that had undergone pterygium surgery, 12 conjunctival autografts were attached using fibrin glue by residents under the observation of one surgeon, and another 12 autografts were sutured in place with 10-0 nylon sutures by a different attending surgeon. A chart review was conducted and patients were reexamined to evaluate differences in: operating time graft success (graft intact 4 weeks postoperatively) pterygium recurrence (growth 1 mm onto cornea) postoperative patient comfort
6 RESULTS SUMMARY DATA OF PATIENTS S/P PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFT FIBRIN GLUE NYLON SUTURES P Value Age (years)126.96.36.1995 Sex (%Male)73500.400 Ethnicity (% Caucasian)45.5750.214 Eye (% OD)45.541.70.256 Surgery duration (min per pterygium) 188.8.131.527 Mean F/U (months)7.411.30.609 Graft Success (%)961001.0 Recurrence (%)184.108.40.2067
CONCLUSION This study suggests that fibrin glue attachment of conjunctival autografts in primary pterygium excision surgery is effective and safe. The fibrin group showed less discomfort and slightly shorter operating time (with residents operating the majority of time in this group) as compared with the standard nylon suturing technique. However, the fibrin group resulted in a higher rate of recurrence. None of these differences was statistically significant. A larger study with the same surgeon performing both surgical techniques may be beneficial in determining whether recurrence is more frequent with the use of fibrin glue.
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