A comparison of fibrin glue with sutures for conjunctival autografts in pterygium excision surgery

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.