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Christina Scelfo, Matthew Gorski, Ira J Udell, Jules Winokur, Carolyn Shih; A Comparison of Recurrence Rates Following Pterygium Surgery Using Suture Materials and Glue. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1605.
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Currently, both amniotic membrane graft (AMG) and conjunctival autograft (CA) are used to repair the conjunctival defect created following pterygium excision. These grafts may be secured in place using various combinations of vicryl or nylon sutures with or without fibrin glue. We conducted a retrospective chart review to compare pterygium recurrence rates following pterygium excision with AMG or CA using different suture materials and fibrin glue or fibrin glue alone.
A retrospective chart review of 99 consecutive eyes that underwent pterygium excision was conducted. Patients included those with primary or recurrent pterygia removed for decreased vision, symptomatic relief, or cosmetic reasons. Severity of pterygia was graded on a scale of 0 to 4 preoperatively. Data was analyzed to determine whether significant variation exists in recurrence rates among grafts secured with nylon or vicryl sutures in combination with fibrin glue or with fibrin glue alone.
A total of 99 eyes—49 males, 50 females—mean age of 57.8 (range 15-90) were included. Of the 99 eyes included in this study, 78 underwent repair with conjunctival autograft versus 21 with amniotic membrane graft. Of those treated with CA, 66 were secured with vicryl sutures and fibrin glue (84.6%), 5 with nylon sutures and fibrin glue (6.4%) and 7 with fibrin glue alone (9.0%). Of those treated with AMG, 13 were secured with vicryl sutures and fibrin glue (61.9%), 3 with nylon sutures and fibrin glue (14.3%), and 5 with fibrin glue alone (23.8%). Eyes in which either type of graft was secured with vicryl sutures and fibrin glue, nylon and fibrin glue or fibrin glue alone had recurrence rates of 12.7%, 12.5% and 8.3%, respectively. All pterygium recurrences received a pre-operative severity score of 3 or 4.
Fibrin glue alone to secure either CA or AMG during pterygium excision yielded a lower recurrence rate than the use of sutures in combination with fibrin glue.
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