Autologous blood versus fibrin glue for conjunctival autograft adherence in sutureless pterygium surgery: a randomised controlled trial.

Abstract

AIMS:

To assess the efficacy of securing conjunctival autograft (CAG) without glue or sutures, using the patient's own blood at the surgical site, and to compare it with the current accepted standard of using fibrin glue for graft adherence, in pterygium surgery.

METHODS:

A single-centre, prospective, randomised controlled trial was carried out in 200 eyes of patients with primary pterygia who were advised pterygium excision with CAG. Enrolled participants were assigned to Group I or II by randomisation. After excision of pterygium, they underwent CAG with autologous blood in Group I (100 eyes) and CAG with fibrin glue in Group II (100 eyes). During follow-up of 1 year, the eyes were assessed for graft adherence and recurrence.

RESULTS:

Of the 200 eyes randomised, 6 eyes that did not complete intended follow-up were excluded from final analysis. Of the 194 eyes (Group I n=96, Group II n=98), on the first postoperative day, 3 eyes in Group I (3.13%) had total graft dislodgement requiring regrafting from another site or reattachment with glue. In Group II also 2 eyes (2.04%) had graft dislodgement on the first postoperative day requiring regrafting from another site. During the 1-year follow-up, 6 eyes in Group I (6.25%) and 8 eyes in Group II (8.16%) developed recurrence.

CONCLUSIONS:

Feasibilty of adherence of the graft without glue in pterygium surgery is promising and has results comparable with the fibrin glue technique in terms of long-term outcome and recurrence, suggesting the potential for autologous blood to replace fibrin glue in graft fixation.

TRIAL REGISTRATION NUMBER:

Clinical Trial Registry, India: CTRI/2013/06/003764 and UTN: U1111-1140-6572.

• Authors: Abraham Kurian, Iodine Reghunadhan, K G R Nair
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 99 Issue 4 Pg. 464-70 (Apr 2015) ISSN: 1468-2079 [Electronic] England
• PMID: 25326519 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• Fibrin Tissue Adhesive
• Tissue Adhesives

Topics

• Adult
• Autografts
• Blood
• Conjunctiva (transplantation)
• Double-Blind Method
• Female
• Fibrin Tissue Adhesive (administration & dosage)
• Graft Survival (drug effects)
• Humans
• Male
• Middle Aged
• Prospective Studies
• Pterygium (surgery)
• Suture Techniques
• Tissue Adhesives (administration & dosage)
• Young Adult