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A. Kim, M. A. Lopez, V. Rojas, A. T. Broman, R. S. Chuck, J. F. Batlle; Comparison of Preserved Amniotic Membrane and Dehydrated Amniotic Membrane Allografting Using Fibrin Glue or Sutures for Attachment After Excision of Primary Pterygium. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5316.
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To compare the effficacy and safety of frozen preserved and dehydrated amniotic membrane allografts using either fibrin glue or sutures for attachment in patients undergoing primary pterygium excision.
A prospective randomized study of 30 eyes of 30 patients undergoing excision of primary pterygium was performed. After pterygium excision, the bare sclera was covered with a frozen preserved amniotic membrane graft in 15 eyes (Group 1) and with a dehydrated amniotic membrane graft in 15 eyes (Group 2). The study groups were further randomized into sub-groups, based upon the technique used to secure the graft: fibrin glue (subgroup 1A, n=8, and subgroup 2A, n=8) and 10-0 nylon sutures (subgroup 1B, n=7, and subgroup 2B, n=7). The patients were followed for approximately one year. The main outcome measures were graft success, recurrence of pterygium, operating time, postoperative complications, and patient comfort.
The mean follow-up period was 24 months. The recurrence rate for Group 1 (33.3%) compared with Group 2 (13.3%) was not significantly different (p = 0.19). The average operating time for grafts attached with fibrin glue was significantly shorter than for grafts attached with sutures (p < 0.001). Post-operative symptoms of foreign body sensation were more frequently observed in individuals who had grafts fixated with sutures compared with individuals with grafts fixated with fibrin glue (p < 0.001). No post-operative complications were seen in Group 1. One individual in Group 2 developed a conjunctival granuloma post-operatively.
Both frozen preserved and dehydrated amniotic membrane transplantation can be safe and effective adjunctive treatments for primary pterygium. Fibrin glue appears to be a safe and effective alternative to attach amniotic membrane grafts after pterygium excision. The fibrin glue technique may result in shorter operating times and less discomfort post-operatively in comparison with attachment of the graft using sutures.
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