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Fibrin adhesive more effective than sutures in pterygium surgery
Cornea. 2010;29(5):485-489.
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Fibrin adhesive in place of sutures during pterygium surgery may reduce the recurrence rate, surgical time and postoperative pain, a study found.
A prospective, randomized, double-blind clinical trial followed 137 eyes of 113 patients who underwent pterygium surgery with conjunctival autograft transplantation using either fibrin adhesive or sutures. Patients were followed up 1 day, 1 week, 1 month, 6 months and 1 year postop.
Of the 68 eyes in the fibrin adhesive group, there were three recurrences as compared with 11 recurrences in the sutures group of 69 patients. The mean duration of surgery in the fibrin adhesive group was 16.93 minutes as compared with the sutures group, which was 29.84 minutes. Patients' immediate postoperative pain score and 1 week postoperative pain score were significantly lower in the fibrin adhesive group.
A disadvantage of the fibrin adhesive procedure is cost. Ten to 12 patients can be operated on using one vial of Tisseel VH, which costs $14 to $17 per patient, whereas sutures cost approximately $7 per patient.
"Ten to 12 patients need to be grouped together and operated on the same day [with fibrin adhesive]," the study authors said. "This may be difficult to do especially in a private setting where the patient load is not so high. Having mentioned that, it is our opinion that if the use of tissue glue reduces the risk of recurrence then the difference is worth the time and cost required for a second surgery."
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