IJCRR - 6(10), May, 2014
Pages: 64-76
COMPARISON OF 'CUT AND PASTE (USING FIBRIN GLUE)' VS 'CUT AND SUTURE (USING 8-0 VICRYL SUTURES)' TECHNIQUES OF PTERYGIUM SURGERY
Author: Kumar Nishant, Vireshwar Prasad, Asif Shahnawaz, Muazzam Ali Akbar
Category: Healthcare
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Abstract:
Background: In recent times, the universal trend toward simpler, quicker and more comfortable surgical procedures have fostered the development of suture-less techniques and hence use of fibrin glue for attaching conjunctival autograft after pterygium excision. Objectives: To assess and compare the mean surgical time, post-operative discomfort and recurrences among patients undergoing Pterygium excision and conjunctival autografting using fibrin glue; with Pterygium excision and conjunctival autografting using 8-0 Vicryl sutures. Materials and methods: 60 patients with primary pterygium randomized into two groups. Group A (n=30) underwent autografting using fibrin glue; Group B (n=30) underwent autografting using 8-0 Vicryl suture. P-value <0.05 was considered statistically significant. Surgical times were noted as: Total surgical time from 1st conjunctival cut to removal of lid speculum, time for excision of pterygium and time to secure graft on the bed. Post operative discomfort was assessed using pretested questionnaires Results: Mean surgical time for Pterygium excision with conjunctival autografting using fibrin glue (15.86min) is significantly less as compared to sutures(27.93min); P=0.001. Post-operative discomfort was significantly less in cases of fibrin glue (10% patients) in comparison to suture group (56.6%patients). The observed difference between the recurrence rates in the group A (3.3%) and Group B (20%) was statistically significant. Conclusion: Fibrin glue reduces the surgical time, post-operative discomfort to the patients and has lower recurrence rates in comparison to conjunctival autografting using sutures following pterygium excision.
Keywords: Pterygium, Conjunctival autografting, 8-0 Vicryl suture, Fibrin glue
Citation:
Kumar Nishant, Vireshwar Prasad, Asif Shahnawaz, Muazzam Ali Akbar. COMPARISON OF 'CUT AND PASTE (USING FIBRIN GLUE)' VS 'CUT AND SUTURE (USING 8-0 VICRYL SUTURES)' TECHNIQUES OF PTERYGIUM SURGERY International Journal of Current Research and Review. 6(10), May, 64-76
References:
REFERENCES
1. Anduze AL, Merritt JC. Pterygium: Clinical Classification and management in Virgin Islands. Ann Ophthalmol 1985; 17: 92-5.
2. Arora Ritu, Goel Monika et al. Fibrin glue Vs Vicryl suture in limbo conjunctival autograft in the management of primary pterygium; a prospective comparative study. AIOC, abstracts. 2010; 262-263.
3. Arrfa R C. Pterygium in: Graysons Disease of the cornea. Mosby year book. 1991:342-5
4. Ashaye AO. Refractive astigmatism and pterygium. Afr J Med Sci 1990;19:225-8.
5. Bahar I, Weinberger D, Dan G, Avisar R. Pterygium surgery: fibrin glue versus Vicryl sutures for conjunctival closure. Cornea.2006 Dec;25(10):1168-72.
6. Bahar Irit, Weinberger Dov, Dan D Gaton and Rahamim Avisar. Fibrin glue versus Vicryl Sutures for Primary conjunctival Closure in Pterygium surgery: Long Term Results. Current Eye Research; 2007, Vol 32, no-5, pages 399- 405.
7. Chan SM, Boisjoly H. Advances in the use of adhesives in ophthalmology. Curr Opin Ophthalmol.2004 Aug;15(4):305-10.
8. Cornand G. Le pterygium in; Terrien F Chirurgie de loeil et des annexes. 1921:376-383.
9. D‘Ombrain A. The Surgical Treatment of pterygium. Br J Ophthalmol 1948; 32: 65-71.
10. Dal Pizzol MM, Roggia MF, Kwitko S, Marinho DR, Rymer S.Use of fibrin glue in ocular surgery. Arq Bras Oftalmol.; 2009 May-Jun;72 (3):308-12.
11. De Kaizer RJ, Swart Vain der Bergh. Results of Pterygium Excision with Sr 90 irradiation, lamellar keratoplasty and conjunctival flaps. Doc ophthalmo 1987; 67:33-44.
12. de Wit D, Athanasiadis I, Sharma A, Moore J. Sutureless and glue-free conjunctival autograft in pterygium surgery: a case series. Eye (Lond) : Epub 2010 Jun 4, 2010 Sep; 24(9):1474-7
13. Dushku N, Tyler N, Reid TW. Immunohistochemical evidence that pterygia arise from altered limbal epithelial basal stem cells. Invest Ophthalmol Vis Science 1993; 34: 1013-20.
14. Farell PL, Smith RE. Bacterial corneoscleritis complicating pterygium excision. AJO 1989 May; 107 (50:515-7)
15. Farid M, Pirnazar JR. Pterygium recurrence after excision with conjunctival autograft: a comparison of fibrin tissue adhesive to absorbable suture. 2009 Jan;28(1):43-5.
16. Fernandes M, Sangwan V S, Bansal A K, Gangopadhaya N, Srihar M S, Garg P, Aasuri M K, Nutheti R and Rao G N. Outcome of Pterygium Surgery: Analysis over 14 years Eye (2005); 19, 1182-1190. Doi:10.1038/sj.eye.6701728; published online 29 October 2004.
17. G Koranyi, S Seregard, E D KoppCut and paste: a no suture, small incision approach to pterygium surgery. Br J Ophthalmol 2004;88:911-914.
18. Goran DH, Hollows FC. Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmology. 1984; 68:343.
19. Hall RC, Logan AJ, Wells AP. Comparison of fibrin glue with sutures for pterygium excision surgery with conjunctival autografts. Clin Experiment Ophthalmol. 2009 Aug;37(6):584-9.
20. Hilgers JM. Pterygium its incidence, heredity and etiology. Am Journal Ophthalmology 1995; 119:236-37.
21. Hirst LW, Battisttutta D, Green A. Risk Analysis in development of pterygia. Ophthalmology 1992 Jul; 99(7): 1056-61.
22. Jap A, Chan C, Lim L, Tan DT. Conjunctival Rotation autograft for pterygium. Ophthalmology 106: 67-71, 1991.
23. Jiang J, Yang Y, Zhang m, Fu X, Yao K. Comparison of fibrin sealant and sutures for conjunctival autograft fixation in pterygium surgery; one year follow up. 2008; 222(2): 105- 11.
24. Kamel S. Pterygium: Its nature and new line of Treatment. Br J Ophthalmology 1946; 30: 549- 63.
25. Karalezii Kucukerdonmez A, Akova Y A, R Altan, Yaycioglu, Borazan. Fibrin glue versus sutures for conjunctival autografting in Pterygium surgery: A Prospective comparative study. Br J Ophthalmology. 2008; 92 (9):1206- 1210.
26. Kim HH, Mun HJ, Park YJ, Lee KW, Shin JP. Conjunctivolimbal autograft using a fibrin adhesive in pterygium surgery. Korean J Ophthalmol.2008 Sep;22(3):147-54.
27. Kunimoto N, Mori. Studies on Pterygium part IV. Nippon Ganka Gakkai Zasshi Acat Societatis Ophthalmologicae Japonica. 1963; 67:601-7.
28. Lewallen S. A randomized trial of conjunctival autografting for Pterygium in the tropics. Ophthalmology. 1989;96:1612.
29. Lucio Burrato, Robert I Phillips, Guiseppe Carito, Pterygium Surgery. 1st edition, Pub. Slack Inc USA pg 15-18.
30. M Ankur, J Poonam et al. Pterygium excision and limbal conjunctival autograftingAstigmatism and Cosmetism. www.aios.org / proceed09 / paper2009 / EXT / Ext7
31. Maheshwari S. Effect of pterygium excision on pterygium induced astigmatism. Indian J Ophthalmology 2003; 51: 187-8.
32. Marticorena J, Rodriguez-Ares MT, Tourino R, Mera P, Valladares MJ, Martinez-de-la-Casa JM, Benitez-del-Castillo JM. Pterygium surgery: conjunctival autograft using a fibrin adhesive. 2006 Jan : 25(1) : 34-6
33. Neal AJ, Irwin C, Hope-Stone HF. Strontium beta irradiation in the management of pterygium. Clin Onc Coll Rad 1991 Mar; 3(2): 105-109.
34. Ozdama Y, Mutevelli S, Han U, IIei D, Onal B, Karahaya J, Eye Research Institute Ankara Turkey. A comparative study of tissue glue and Vicryl sutures for closing limbal conjunctival autograft and histological evaluation after Pterygium excision. 2008 July; 27(6): 663-7
35. Pinkerton OD, Hokama Y, shigemura LA. Immunological basis for the pathogenesis of Pterygium. Am Journal Ophthalmology 1984; 98: 225-28.
36. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of Conjunctival Autografts, amniotic membrane grafts and primary closure of conjunctival grafts ophthalmology 104; 974- 85, 1997.
37. Rajiv S, Mittla S, Sood AK. Pterygium and dry eye, a clinical correlation. Indian J Ophthalmology. 1991 Jan-Mar: 39(1); 15-6.
38. Sarnicola V, Vannozzi L, Motolese PA. Recurrence rate using fibrin glue-assisted ipsilateral conjunctival autograft in pterygium surgery: 2-year follow-up. Cornea: 2010 Nov; 29(11):1211-4.
39. Sebban A, Hirst L W. Pterygium Recurrence Rate at the Princess Alexandra Hospital. Aust NZ J Ophthalmol 1991; 19: 203-6a.
40. Srinivasan S, Dollin M, McAllum P, Berger Y, Rootman DS, Slomovic AR. Fibrin glue versus sutures for attaching the conjunctival autograft in pterygium surgery: a prospective observer masked clinical trial. Br J Ophthalmol.2009 Feb;93(2):215-8.
41. Uy HS, Reyes JM, Flores JD, Lim-Bon-Siong R. Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision. Ophthalmology.2005 Apr;112(4):667- 71.
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