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Sealing conjunctival autograft with fibrin glue may better prevent pterygium recurrence

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LAS VEGAS — Sealing a conjunctival autograft with tissue adhesive may better protect against pterygium recurrence than absorbable sutures, according to a surgeon speaking here.

Marjan Farid

At the American Academy of Ophthalmology meeting, Marjan Farid, MD, presented a retrospective review of 47 eyes of 42 patients with pterygium who were treated with excision and conjunctival autograft.

According to Dr. Farid, 27 grafts were sealed with Tisseel tissue adhesive (Baxter AG) and 20 with absorbable sutures. At a minimum follow-up of 6 months, the researchers found that pterygia had recurred in 20% of the suture group but in only 3.7% of the adhesive group (P = .035), she said.

"It is unclear exactly why recurrence occurs. There is evidence to suggest that there is a transformation of the phenotypic characteristics of the conjunctival fibroblasts, which is triggered by ultraviolet radiation or inflammation. Certainly absorbable sutures can be very inflammatory, drawing in the ... cytokines that trigger recurrence," Dr. Farid said.