Fibrin adhesive better than sutures for pterygium surgery

The authors of this double-blind study randomized 113 patients (137 eyes) with primary pterygium to undergo conjunctival autografting using fibrin adhesive (Tisseel VH, Baxter Healthcare Corp.) or sutures and followed them for one year. The results of the study, believed to be the largest one to date comparing these treatments, indicate that the pterygium recurrence rate, postoperative pain and surgical time were all reduced when fibrin adhesive was used.

After one year, the recurrence rate in the fibrin adhesive group was 4.41 percent, significantly lower than in the suture group (15.9 percent). This may be due to reduced postoperative inflammation, the authors said. Surgical duration with fibrin adhesive was 16.93 minutes compared with 29.84 minutes with sutures (P < 0.001). Postoperative pain immediately after surgery and after one week was significantly lower in the fibrin adhesive than the suture group, despite similar pain scores between the groups preoperatively and one day after surgery.

The authors conclude that conjunctival autografting is easier with fibrin adhesive, requiring minimal graft manipulation and resulting in less inflammation and greater patient comfort.