A comparison of fibrin glue with sutures for conjunctival autografts in pterygium excision surgery
Date
2015-09-04
Authors
Sandri, Lara
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Abstract
To assess post-operative patient comfort and graft success following
conjunctival autografts with sutures compared with Tisseel glue for pterygium surgery, and
to identify which procedure was the more cost-effective surgical option.
Design and Methods: A prospective randomized comparison of 60 patients undergoing
primary pterygium surgery at St John Eye Hospital between April 2012 and September
2012. A post-operative comfort scale was used to assess foreign body sensation, sensitivity
to light, tearing and itchiness. Graft success was defined as a graft that was still adherent at
one month following surgery.
Results: Patients in the Tisseel glue group experienced significantly less foreign body
sensation (p=0.038) and itchiness (p=0.018) on day-one after surgery, compared to those in
the suture group. At one-month follow-up patients had significantly less foreign body
sensation (p=0.042), sensitivity to light (p=0.001), and itchiness (p=0.009) in the Tisseel
glue group compared to the suture group. Autograft adherence was seen in all 60 patients
at the one-month follow-up visit. Both the surgical time and the indirect costs of the
procedure were reduced in the Tisseel glue group.
Conclusions: The use of Tisseel glue for attaching autografts in pterygium surgery is an
effective method with global autograft success, less post-operative discomfort and shorter
operating times.
Description
A dissertation submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of
Master of Medicine in Ophthalmology
Johannesburg 2015