Comparative analysis of different surgical techniques for pterygium management

Abstract

Purpose The study goal is to compare the safety, efficacy, and recurrence rate between blood coagulum, polyglactin sutures, and fibrin glue usage in the fixation of the conjunctival graft in pterygium surgery. Patient and methods The study included 120 patients randomly grouped into three groups, each group included 40 patients. The study was accommodated on the patients attending Beni Suef University hospital and MUST hospital. Group (A): includes 40 patients who were managed with in situ blood coagulum. Group (B): includes 40 patients who were managed with the fibrin glue fixation of autografts. Group (C) include 40 patients who were managed with polyglactin sutures fixation of the autograft. Results The mean age was 41±4.1 years old, with no statistically significant differences among the studied groups in duration of surgery and recurrence. In the present study, we found that there was a statistically significant difference among the study groups ( P =0.001). Group (C) had the longest duration (mean duration in min 25.6±5.5) while the group (A) had a longer duration in minutes (mean of 23.7±4.1) than group (B) with (mean of 19.2±4.5 min). There was a statistically significant difference among the study groups regarding the graft dislocation after one week and one month of follow-up, with better stability in group (C): Regarding the recurrence rate, higher recurrence was present in group (A) (10.0%) compared with only (5.0%) among group (B), the least recurrence rate was found in group (C) (2.5%). However, that difference was not statistically significant ( P =0.604). Conclusion Fixation of the conjunctival autograft with polyglactin sutures was associated with the least recurrence rate and the longest duration followed by the application of fibrin glue, while the glue free autologous blood coagulum showed the highest recurrence rate and the shortest duration.