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First Author: P.Ramos PORTUGAL
Co Author(s): K. Sousa J. Rosendo A. Pepo A. Candeias
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To determine the recurrence and the postoperative complications in primary pterygium treated with conjunctival autograft and adjunctive fibrin glue
The authors report a retrospective study that included fifty-two conjunctival autograft surgeries performed by residents, in their first year experience with this technique, in the ophthalmology department of the Hospital Espirito Santo de Évora - Portugal.
Fifty-two eyes of 50 patients with primary pterygium underwent surgical excision followed by removal of subconjuntival fibrovascular tissue. Then they were submitted to conjunctival autograft with adjunctive use of fibrin glue. Before surgery, the morphologic features of pterygium were graded according to what was described by Tan and associates: grade T1 (atrophic pterygium in which episcleral vessels were unobscured by the body of pterygium), grade T2 (partially obscured episcleral vessels) and grade T3 (fleshy pterygium in which episcleral vessels were totally obscured). Main outcome measures included corneal and conjunctival recurrence in a 12 month follow-up, postoperative complications and adverse reactions related to the use of fibrin glue.
Before surgery 9% of our cases were graded as T1, 57% as T2 and 34% as T3. We report a total recurrence rate of 7.7% (0% recurrence in T1). The most common minor complication was conjunctival retraction in 11.5% of our cases. We do not report any graft loss, major complications or adverse reactions related to the use of fibrin glue.
Conjunctival autograft surgery for primary pterygium is an effective procedure with a low rate of recurrence. The use of adjunctive fibrin glue is a safe and effective procedure that has the potential to decrease operative time, increase ease of technique, and improve patient comfort postoperatively.