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Fibrin glue versus autologous blood for conjunctival autograft fixation in pterygium surgery

      Abstract

      Objective

      To compare the outcomes between autologous blood- and fibrin glue–fixated conjunctival autografts in pterygium excision surgery.

      Design

      Retrospective case series.

      Participants

      Forty eyes of 40 patients who had a primary nasal pterygium excision.

      Methods

      A retrospective comparative case series of 40 eyes (40 patients) that had a primary nasal pterygium excision. All eyes had a conjunctival autograft from the superior bulbar conjunctiva to cover the scleral bed. Twenty eyes (20 patients) had fixation of the autograft using autologous blood (AB), and 20 eyes (20 patients) had fixation using fibrin glue (FG). One year of follow-up data included conjunctival graft stability (graft loss, graft retraction), pterygium recurrence, visual acuity, and postoperative complications. Descriptive and inferential statistics were performed.

      Results

      Intraoperatively, no complications occurred in either group. Graft loss occurred in 6 patients in the AB group, compared with none in the FG group. Graft retraction occurred in 3 patients in the AB group and 2 patients in the FG group. At 1 year postoperatively, pterygium recurrence occurred in 4 patients in the AB group and 1 patient in the FG group. One patient in the AB group developed a small pyogenic granuloma that resolved by 6 months with conservative management. Visual acuity remained stable in both groups.

      Conclusions

      Conjunctival autograft fixation with autologous blood resulted in less stable conjunctival autografts and a higher recurrence rate compared with fixation with fibrin glue.

      Résumé

      Objet?>

      Comparer les résultats, dans des cas d’excision du ptérygion, entre l’utilisation de sang autologue et l’utilisation de colle à la fibrine pour une autogreffe conjonctivale.

      Nature?>

      Étude de cas rétrospective.

      Participants?>

      40 yeux de 40 patients ayant subi une excision du ptérygion primaire en nasal.

      Méthodes?>

      Étude de cas rétrospective comparative de 40 yeux (40 patients) ayant subi une excision du ptérygion primaire en nasal. Tous les yeux ont reçu une autogreffe conjonctivale de la conjonctive bulbaire supérieure pour couvrir la cavité sclérale. Pour 20 yeux (20 patients), l’autogreffe a été fixée à l’aide de sang autologue (SA), et pour les 20 autres (20 patients), à l’aide de colle à la fibrine (CF). À l’examen de suivi de 12 mois, ont été examinés : la stabilité de la greffe conjonctivale (résorption ou rétraction du greffon), la récurrence du ptérygion, l’acuité visuelle et les complications postopératoires. Des statistiques descriptives et déductives ont été calculées.

      Résultats?>

      Pendant l’opération, aucune complication n’a été constatée dans les deux groupes. Une résorption du greffon a été constatée chez 6 patients du groupe SA, mais chez aucun du groupe CF. Une rétraction du greffon a été constatée chez 3 patients du groupe SA et chez 2 patients du groupe CF. Après le suivi de 12 mois, une récurrence du ptérygion a été signalée chez 4 patients du groupe SA et chez 1 patient du groupe CF. Un patient du groupe SA a développé un petit granulome pyogène qui s’est résorbé après 6 mois de traitement. L’acuité visuelle est demeurée stable chez les patients des deux groupes.

      Conclusions?>

      L’utilisation de sang autologue pour une autogreffe conjonctivale donne des résultats moins stables et un taux de récurrence plus élevé que l’utilisation de colle à la fibrine.
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