Long Term Outcomes On Pterygium Excision With Conjunctival Autograft With Fibrin Glue

Published 2024 - 42nd Congress of the ESCRS

Reference: PO909 | Type: Free paper | DOI: 10.82333/mj3d-9h42

Authors: Justine Griffith* ¹ , Loredana Smarandache ¹ , Sathish Srinivasan ²

¹University Hospital Ayr,Ayr,United Kingdom, ²University Hospital Ayr,Ayr,United Kingdom;University of the West of Scotland,Glasgow,United Kingdom

Purpose

To report the long-term outcomes on graft stability and recurrence rates following pterygium excision with conjunctival autograft (PECA) with fibrin glue for primary pterygium.

Setting

Single center, single surgeon, retrospective study.

Methods

Medical records of patients that underwent PECA with fibrin glue for primary pterygium by a single surgeon (SS) from 2010 to 2023 at University Hospital Ayr, Ayr, Scotland. All surgical procedure was performed under local anesthesia and in all cases fibrin glue (no sutures) was used to secure the conjunctival autograft to the bare sclera. Postoperatively all subjects were treated with topical antibiotics for 4 weeks and steroids were slowly tapered based on the clinical response. Data on demographics, graft stability, intra and postoperative complications, and recurrence were collected. Patients were excluded if complete medical records were unavailable for data collection.

Results

61.97 % of this cohort were men with a mean age of 57 years old. 57.75 % had primary nasal pterygium. There were no intraoperative complications. The mean follow-up of this cohort was 34 months (1 to 96 months). One patient had early post-operative graft dehiscence which required surgical repositioning with glue and sutures. 26.76 % developed topical steroid-induced pressure spikes that were managed with medical intervention. 5.63% developed post-operative pyogenic granuloma that self-resolved (1 case), was managed with steroid drops (2 cases), and was surgically excised (1 case). 5.63% developed pterygium recurrence, from which 1 case was treated with 3 subconjunctival injections with anti-VEGF, and 1 case requiring repeat surgery.

Conclusions

Pterygium excision with conjunctival graft with fibrin glue is a safe and effective treatment option for primary pterygium with a very low recurrence rate. Fibrin glue is a safe and effective alternative to sutures. These patients need long-term follow-up to monitor steroid-induced pressure spikes.