Skip to main content
SpringerLink
Log in

Comparison of autologous in situ blood coagulum versus sutures for conjunctival autografting after pterygium excision

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Our aim was to compare the efficacy and safety of autologous in-situ blood coagulum versus sutures for attaching conjunctival limbal autografts (CAG) among patients undergoing primary pterygium excision over a period of 1 year. Thirty-two eyes of 32 patients with primary pterygium were randomly divided in into two groups: group I (16 eyes) underwent CAG with 10-0 monofilament nylon sutures and group II (16 eyes) underwent CAG with patient’s own in-situ blood coagulum acting as bioadhesive or fixative followed by bandaging for 48 h. Patients were followed up postoperatively on the 2nd day, 1 week, 2 weeks, 4 weeks, and 12 months. All the surgeries were done by the same surgeon. Graft success, recurrence rate, operating time, patient comfort, graft retraction or any other complication were studied. The duration of surgery was significantly less (P < 0.001) in group II (mean duration 15 ± 2 min) than group I (mean duration 67 ± 2 min). Postoperative symptoms were fewer for group II than group I. Rate of recurrence was equal in both groups (one patient in each group, 6.25 %). But complications regarding graft failure and graft retraction were more common in group II (two patients, 12.5 %) than group I (one patient, 6.25 %); however, the difference was not statistically significant (Z = 0.61). Thus, autologous in-situ blood coagulum is a useful method for graft fixation in pterygium surgery with shorter operating time and less postoperative discomfort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Moran DJ, Hollows FC (1984) Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmol 68(5):343–346

    Article  CAS  PubMed  Google Scholar 

  2. Taylor HR, West S, Muñoz B (1992) The long-term effects of visible light on the eye. Arch Ophthalmol 110(1):99–104

    Article  CAS  PubMed  Google Scholar 

  3. Rubinfeld RS, Pfister RR, Stein RM (1992) Serious complications of topical mitomycin-C after pterygium surgery. Ophthalmology 99:1647–1654

    Article  CAS  PubMed  Google Scholar 

  4. Sanchez-Thorin JC, Rocha G, Yelin JB (1998) Meta-analysis on the recurrence rates after bare sclera resection with and without mitomycin C use and conjunctival autograft placement in surgery for primary pterygium. Br J Ophthalmol 82:661–665

    Article  CAS  PubMed  Google Scholar 

  5. Hayasaka S, Noda S, Yamamoto Y, Setogawa T (1998) Postoperative instillation of low-dose mitomycin C in the treatment of primary pterygium. Am J Ophthalmol 106(715–71):8

    Google Scholar 

  6. Talu H, Tasindi E, Ciftci F, Yildiz TF (1998) Excimer laser phototherapeutic keratectomy for recurrent pterygium. J Cataract Refract Surg 24:1326–1332

    Article  CAS  PubMed  Google Scholar 

  7. Amano S, Motoyama Y, Oshika T et al (2000) Comparative study of intraoperative mitomycin C and beta irradiation in pterygium surgery. Br J Ophthalmol 84:618–621

    Article  CAS  PubMed  Google Scholar 

  8. Dadeya S, Kamlesh Khurana C, Fatima S (2002) Intraoperative daunorubicin versus conjunctival autograft in primary pterygium surgery. Cornea 21:766–769

    Article  PubMed  Google Scholar 

  9. Akarsu C, Taner P, Ergin A (2003) 5-Fluorouracil as chemoadjuvant for primary pterygium surgery: preliminary report. Cornea 22(522–52):6

    Google Scholar 

  10. Kenyon KR, Wagoner MD, Hettinger ME (1985) Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 92:1461–1470

    Article  CAS  PubMed  Google Scholar 

  11. Starck T, Kenyon KR, Serrano F (1991) Conjunctival autograft for primary and recurrent pterygia: surgical technique and problem management. Cornea 10:196–202

    Article  CAS  PubMed  Google Scholar 

  12. Allan BD, Short P, Crawford CJ (1993) Pterygium excision with conjunctival autografting: an effective and safe technique. Br J Ophthalmol 77:698–701

    Article  CAS  PubMed  Google Scholar 

  13. Chen PP, Ariyasu RG, Kaza V (1995) A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 120:151–160

    CAS  PubMed  Google Scholar 

  14. Prabhasawat P, Barton K, Burkett G, Tseng SC (1997) Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 104:974–985

    Article  CAS  PubMed  Google Scholar 

  15. Tan DT, Chee SP, Dear KB, Lim AS (1997) Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 115:1235–1240

    Article  CAS  PubMed  Google Scholar 

  16. Ti SE, Chee SP, Dear KB, Tan DT (2000) Analysis of variation in success rates in conjunctival autografting for primary and recurrent pterygium. Br J Ophthalmol 84:385–389

    Article  CAS  PubMed  Google Scholar 

  17. Sridhar MS, Bansal AK, Rao GN (2002) Surgically induced necrotizing scleritis after pterygium excision and conjunctival autograft. Cornea 21:305–307

    Article  CAS  PubMed  Google Scholar 

  18. Cohen RA, McDonald MB (1993) Fixation of conjunctival autografts with an organic tissue adhesive [letter]. Arch Ophthalmol 111(1167–116):8

    Google Scholar 

  19. Koranyi G, Seregard S, Kopp ED (2004) Cut and paste: a no suture, small incision approach to pterygium surgery. Br J Ophthalmol 88:911–914

    Article  CAS  PubMed  Google Scholar 

  20. Zauberman H, Hemo I (1988) Use of fibrin glue in ocular surgery. Ophthalmic Surg 19(2):132–133

    CAS  PubMed  Google Scholar 

  21. Lagoutte FM, Gauthier L, Comte PR (1989) A fibrin sealant for perforated and preperforated corneal ulcers. Br J Ophthalmol 73(9):757–761

    Article  CAS  PubMed  Google Scholar 

  22. Mandel MA (1990) Closure of blepharoplasty incisions with autologous fibrin glue. Arch Ophthalmol 108(6):842–844

    Article  CAS  PubMed  Google Scholar 

  23. Bartley GB, McCaffrey TV (1990) Cryoprecipitated fibrinogen (fibrin glue) in orbital surgery. Am J Ophthalmol 109(2):227–228

    CAS  PubMed  Google Scholar 

  24. Kajiwara K (1990) Repair of a leaking bleb with fibrin glue. Am J Ophthalmol 109(5):599–601

    CAS  PubMed  Google Scholar 

  25. Kaufman HE, Insler MS, Ibrahim-Elzembely HA, Kaufman SC (2003) Human fibrin tissue adhesive for sutureless lamellar keratoplasty and scleral patch adhesion: a pilot study. Ophthalmology 110(11):2168–2172

    Article  PubMed  Google Scholar 

  26. Ratnalingam V, Eu AL, Ng GL, Taharin R, John E (2010) Fibrin adhesive is better than sutures in pterygium surgery. Cornea 29(5):485–489

    Article  PubMed  Google Scholar 

  27. Hino M, Ishiko O, Honda KI (2000) Transmission of symptomatic parvovirus B19 infection by fibrin sealant used during surgery. Br J Haematol 108(1):194–195

    Article  CAS  PubMed  Google Scholar 

  28. Kawamura M, Sawafuji M, Watanabe M (2002) Frequency of transmission of human parvovirus B19 infection by fibrin sealant used during thoracic surgery. Ann Thorac Surg 73(4):1098–1100

    Article  PubMed  Google Scholar 

  29. Ozcan AA (2008) Autologous human fibrin glue in multilayered amniotic membrane transplantation. Ann Ophthalmol (Skokie) 40(2):107–109

    Google Scholar 

  30. Gammon RR, Prum BE Jr, Avery N, Mintz PD (1998) Rapid preparation of small-volume autologous fibrinogen concentrate and its same day use in bleb leaks after glaucoma filtration surgery. Ophthalmic Surg Lasers 29(12):1010–1012

    CAS  PubMed  Google Scholar 

  31. Asrani SG, Wilensky JT (1996) Management of bleb leaks after glaucoma filtering surgery. Use of autologous fibrin tissue glue as an alternative. Ophthalmology 103(2):294–298

    Article  CAS  PubMed  Google Scholar 

  32. Mandel MA (1992) Minimal suture blepharoplasty: closure of incisions with autologous fibrin glue. Aesthetic Plast Surg 16(3):269–272

    Article  CAS  PubMed  Google Scholar 

  33. Wit D, Athanasiadis I, Sharma A, Moore J (2010) Sutureless and glue free conjunctival autograft in pterygium surgery: a case series. Eye 24:1474–1477

    Article  PubMed  Google Scholar 

  34. Malik KPS, Goel R, Gupta A, Gupta SK, Kamal S, Malik VK, Singh S (2012) Efficacy of sutureless and glue free limbal conjunctival autograft for primary pterygium surgery. Nepal J Ophthalmol 4(8):230–235

    CAS  PubMed  Google Scholar 

  35. Uy HS, Reyes JM, Flores JD, Lim-Bon-Siong R (2005) Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision. Ophthalmology 112:667–671

    Article  PubMed  Google Scholar 

  36. Srinivasan S, Slomovic AR (2007) Eye rubbing causing conjunctival graft dehiscence following pterygium surgery with fibrin glue. Eye 21:865–867

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Regional Institute of Ophthalmology, Medical College and Hospital, Kolkata, West Bengal, India

    Somnath Choudhury, Sumanta Bera, Smruti Savale, Debanjan Sen & Himadri Datta

  2. Department of Ophthalmology, IPGME&R, Kolkata, West Bengal, India

    Jayanta Dutta

  3. Department of Ophthalmology, NRS Medical College, Kolkata, West Bengal, India

    Somnath Mukhopadhyay

  4. Department of Community Medicine, NRS Medical College and Hospital, Kolkata, West Bengal, India

    Rivu Basu

Authors
  1. Somnath Choudhury
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jayanta Dutta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Somnath Mukhopadhyay
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rivu Basu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sumanta Bera
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Smruti Savale
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Debanjan Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Himadri Datta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jayanta Dutta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Choudhury, S., Dutta, J., Mukhopadhyay, S. et al. Comparison of autologous in situ blood coagulum versus sutures for conjunctival autografting after pterygium excision. Int Ophthalmol 34, 41–48 (2014). https://doi.org/10.1007/s10792-013-9790-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-013-9790-y

Keywords

Search

Navigation