Modified Sutureless and Glue-Free Method Versus Conventional Sutures for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Randomized Controlled Trial

Yan, Bin; Peng, Li; Peng, Hanhan; Zhou, Shu; Chen, Baihua

doi:10.1097/ico.0000000000002137

Cited by 12 publications

(35 citation statements)

References 29 publications

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“…Group B had more redness and less symptoms which was otherwise in group A. Similar findings in few other studies quoting better patient satisfaction and postoperative symptoms in the blood coagulum group than the other techniques [15,16] . For more correlations, we recorded graft size in each case, graft size was measured in terms of breadth and length (longest measurement of graft from limbus) Our study focusses on time wise analysis of outcomes of both the surgeries.…”

Section: Discussionsupporting

confidence: 84%

To compare conjunctival autografting with autologous serum against fibrin glue in pterygium excision

Dabhade¹,

Chahande²

2021

Int. J. Med. Ophthalmol.

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The study included 60 eyes having all nasal primary pterygium. Simple excision was performed followed by closure of the bare sclera by conjunctival autograft by the known method of fibrin glue in 30 eyes (Group A) versus autologous serum (Group B). During follow-up of 3 months, the eyes were assessed in comprehensive manner on postop day one, one month and third month. Outcome measures were assessed by cosmesis, operative time, postoperative recovery, graft inflammation, subconjunctival haemorrhage [SCH], Graft stability and recurrence. Average operative time in group A and group B were 18 minutes and 27 minutes respectively. Postoperative findings like graft oedema in conjunctival inflammation were more or less similar in both groups. In terms of graft stability, there were 1 (3.3%) graft loss in group A versus 2 (6.7%) graft loss. 2 (6.7%) partial displacements seen in group A whereas 4 (13.3%) partial displacements in group B. Most common finding in group B was SCH which made poor cosmesis but it lasted 2-3 weeks. There was one granuloma in group A. Both groups had same recurrence rate of 6.7%. Also graft retraction seen in 2 eyes each in either group. Autologous serum glue method is safe, efficacious and cost effective yet not commonly performed. As per our study, this method is associated with less postoperative discomfort with success rates that are comparable to fibrin glue.

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Section: Discussionsupporting

confidence: 84%

To compare conjunctival autografting with autologous serum against fibrin glue in pterygium excision

Dabhade¹,

Chahande²

2021

Int. J. Med. Ophthalmol.

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“…This is similar to a study conducted by Elwan, (2014) where he reported lower postoperative symptoms in sutureless groups than with sutures. Postoperative symptoms were reported to be lesser in the sutureless group in many studies (Sati et al, 2014;Sharma et al, 2015;Yan et al, 2019).…”

Section: Discussionmentioning

confidence: 95%

“…Sutureless technique either with fibrin glue or autologous fibrin can have less discomfort than sutured technique when securing the graft. (Elwan, 2014;Yan et al, 2019;Yüksel et al, 2010) Fibrin glue which is used as an alternative to sutures for adhesion of the autologous graft, decreases postoperative pain and shorten the surgery time. (Koranyi et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

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Sutureless Glue Free Versus Sutured Limbal Conjunctival Autografts in Primary Pterygium Surgery

2021

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Introduction: Surgical excision is the definitive treatment for pterygium. Following excision, conjunctival autograft is usually preferred. Various methods for grafting with sutures, glue or autologous serum from the recipient bed are in use. The objective of this study was to compare surgical outcomes of sutureless glue free conjunctival autograft with sutured (vicryl 8-0) conjunctival autograft in primary pterygium excision. Materials and methods: A prospective randomized interventional study was carried out in 100 eyes with primary pterygium. They were divided into two groups for conjunctival graft adhesion; sutureless glue free (group 1; n=50 eyes) and sutured with absorbable (vicryl 8-0) suture (group 2; n=50 eyes). Time taken for surgery, complications, postoperative symptoms and overall satisfaction score were noted. The patients were followed up on day 1, day 14 and 6 weeks after surgery. Recurrence was noted till 1 year after surgery. Results: The mean age was 46.76 ± 11.97 years (group 1) and 47.24±12.76 years (group 2). Group 1 had shorter duration of surgery (p<0.001), less postoperative complaints (p<0.001) and better patient satisfaction (p<0.001) than group 2. Postoperative complications and gain in visual acuity in both the groups were not clinically significant. Recurrence was not significant in both groups until 1 year of follow up. Conclusion: Pterygium surgery with sutureless glue free conjunctival autograft had fewer postoperative complaints and better patient satisfaction than pterygium surgery with sutured conjunctival autograft. The postoperative complications, recurrence were comparable to conventional sutured technique.

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“…Thus, there has been an increased enthusiasm among the ophthalmologists to use fibrin glue or autologous blood to simplify the surgical procedure and reduce patient discomfort successfully [ 3 – 6 ]. Recently, we have reported a modified sutureless, glue-free method to fix the conjunctival autograft, which proved to be effective, time-saving, along with a decreased recurrence rate and improved postoperative comfort [ 7 ]. Previous studies have shown that pterygium surgery may affect refractive status of the eye [ 8 ], but to date, there is no study on the visual quality of the new modified sutureless and glue-free method.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of optical quality in pterygium patients with a new modified sutureless and glue-free method

et al. 2021

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Background Modified sutureless and glue-free method is an effective and novel surgical approach for pterygium. We aim to evaluate optical quality in pterygium treated with the new method and investigate the clinical application of the Optical Quality Analysis System (OQAS) and Anterior segment optical coherence tomography (AS-OCT) to evaluate the pterygium surgery. Methods A total of 52 eyes of 52 patients with pterygium were randomly divided into 2 groups. After surgical excision, the bare sclera was placed with a tight fit limbal conjunctival autograft fixed via the modified sutureless and glue-free method in group 1 (26 eyes) and conventional sutures in group 2 (26 eyes). Objective scattering index (OSI), modulation transfer function (MTF) and Strehl ratio (SR) were measured using OQAS in both groups during the perioperative period. Pterygium diameter was measured on AS-OCT. Ocular surface disease index (OSDI) questionnaire also was used. Results The group 1 had significantly lower mean OSI, higher mean MTF, and higher mean SR at 1 month and 3 months after surgery (p < 0.05). The group 1 had significantly lower mean OSDI at 1 month (p < 0.05), while was similar to group 2 at 3 months (p > 0.05). Pterygium diameter positively correlated with OSI (r = 0.528, p < 0.001), while it negatively correlated with MTF (r = − 0.501, p < 0.001) and SR (r = − 0.174, p = 0.217) before operation. Conclusions The modified sutureless and glue-free method might be more advantageous in improving the optical quality during early postoperative recovery times and pterygium diameter affected optical quality. OQAS can be reliably used to evaluate postoperative outcomes.

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Modified Sutureless and Glue-Free Method Versus Conventional Sutures for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Randomized Controlled Trial

Cited by 12 publications

References 29 publications

To compare conjunctival autografting with autologous serum against fibrin glue in pterygium excision

To compare conjunctival autografting with autologous serum against fibrin glue in pterygium excision

Sutureless Glue Free Versus Sutured Limbal Conjunctival Autografts in Primary Pterygium Surgery

Evaluation of optical quality in pterygium patients with a new modified sutureless and glue-free method

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