A COMPARATIVE STUDY TO EVALUATE THE OUTCOME OF SUTURES VERSUS FIBRIN GLUE IN CONJUNCTIVAL AUTOGRAFT TECHNIQUE FOR PRIMARY PTERYGIUM EXCISION

2021 ◽  
Vol 8 (1) ◽  
pp. 23-27
Author(s):  
Dr. Sonali Biradar ◽  
Dr. Ajay Tammewar ◽  
Dr. Roopa Naik
Keyword(s):  
Fibrin Glue ◽  
Surgical Removal ◽  
Ocular Motility ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Suture Group ◽  
Pterygium Excision ◽  
Conjunctival Autografting ◽  
Primary Pterygium ◽  
Postoperative Discomfort

Background: Pterygium is degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue and is characterized by formation of a triangular fold of conjunctiva encroaching on the cornea leading  to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem.  Now, Fibrin glue is being tried since few years to secure grafts in place of the sutures. The objective of this study was to compare duration of surgery, immediate postoperative complications which includes an inflammation, subconjunctival hemorrhage, patient comfort, graft stability between the uses of fibrin glue versus sutures. Methods:  A total of 40 patients having primary pterygium were included in the study. 20 patients were underwent pterygium excision surgery and conjunctival autografting using absorbable vicryl 8-0 suture and 20 patients underwent pterygium excision surgery and conjunctival autografting using fibrin glue.  These 2 groups were compared in terms of duration of the surgery, inflammation, degree of postoperative discomfort, subconjunctival haemorrhage and graft stability at postoperative day 1. Results: The mean surgery time in fibrin glue group was 15 minutes and mean surgery time in suture group was 28 minutes (p=0.000). Fibrin glue group had significantly lesser inflammation (p=0.001) as well as postoperative discomfort (p=0.000) compared to suture group at postoperative day 1. There was no significant difference found in the degree of subconjunctival haemorrhage between the fibrin glue versus sutures groups (p=0.887 and p=0.797 at day 1). The grafts secured with fibrin glue were as stable as those secured with the sutures (p=0.745, 0.644 at day 1). Conclusion: The fibrin glue group in conjuctival autografting had significantly less surgery time, which also produces significantly less postoperative discomfort as well as inflammation with grafts being as stable as those secured with sutures. Fibrin glue can be used regularly if patients can be pooled together and operated on, by making it cost effective procedure.

scholarly journals Outcome Of The Use Of Autologous Blood Serum, Fibrin Glue And Vicryl Suture In Conjunctival Autograft Transplant Following Pterygium Surgery.

2020 ◽  
Vol 7 (06) ◽  
pp. 4860-4864
Author(s):  
BRIJESH SINGH ◽  
MEENU BABBER ◽  
IFSA SAMI
Keyword(s):  
Fibrin Glue ◽  
Autologous Blood ◽  
Autologous Serum ◽  
P Value ◽  
Conjunctival Autograft ◽  
Suture Group ◽  
Group A ◽  
Group B ◽  
Conjunctival Autografting ◽  
Postoperative Discomfort

Background: Pterygium is a common ophthalmological problem in India. Excision of pterygium with conjunctival autograft is the main line of treatment. Many modifications of surgical techniques have been tried like conjunctival autografting with fibrin glue, sutures and autologous serum. All these modalities have their pros and cons. We compared these techniques for conjunctival autografting following pterygium surgery. Methods: A randomized interventional study was performed on 60 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a conjunctival autograft, which was fixed using autologous blood serum(in Group A, n=20), fibrin glue(in Group B, n=20) and vicryl suture (8-0) (in Group C, n=20). The patients were examined on postoperative Day 1, 1 week, 1month, 3 month and 6 month. The main outcome measures were operative time ,autograft stability, postoperative discomfort, autograft thicknes, pterygium recurrence and granuloma formation. Results: The mean operative time was significantly shorter in group A(23.60 min) followed by Group B (25.20 min) and Group C(28.15 min)(p-value <0.0001).Postoperative discomfort measured on visual analogue scale was minimal in fibrin group (p-value=0.0008) and maximum in suture group. Graft displacement was found in 2(10%) patient in autologous blood group (p value=0.349) while Graft oedema, granuloma & recurrence was noted in suture group only(p value=0.362). Conclusions: The conjunctival autografting with fibrin glue proved to be better method than autologous serum and suture, as it had very less postoperative discomfort, no recurrence, minimal edema and less graft displacement.

scholarly journals Superior versus Inferior Conjunctival Limbal Autograft with Sutures in the Management of Primary Pterygium in a Tertiary Care Hospital in Dakshina Kannada - A Cross Sectional Study

2021 ◽  
Vol 8 (11) ◽  
pp. 603-607
Author(s):  
Madhuri Upadhyaya ◽  
Sheetal Savur
Keyword(s):  
Cross Sectional Study ◽  
Bulbar Conjunctiva ◽  
Care Hospital ◽  
Sectional Study ◽  
Surgical Time ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean ◽  
Pterygium Excision ◽  
Primary Pterygium

BACKGROUND Pterygium excision with conjunctival limbal autograft (CAU) is one of the most frequently used modalities in the treatment of pterygium. The graft has traditionally been harvested from the superior bulbar conjunctiva, but this may not be possible in all patients. The purpose of this study was to compare the intraoperative difficulties and early postoperative outcomes between superior and inferior CAU in the management of primary pterygium. METHODS This hospital based cross sectional study evaluated 58 eyes of 50 patients with primary pterygium who underwent pterygium excision with conjunctival limbal autograft secured with the help of sutures over a period of 2 years from March 2018 to March 2020. In 28 eyes, the superior bulbar conjunctiva was used for grafting whereas in 30 eyes, the inferior conjunctiva was used for the same. The outcome measured was in terms of the mean surgical time, clinical symptoms and signs in the early postoperative period and recurrence rate. RESULTS The mean age of the patients was 44.14 ± 12.71 years in the superior CAU group and 45.76 ± 14.51 years in the inferior CAU group. There was no statistically significant difference between the two groups in terms of the mean surgical time (68.39 ± 31.51 in superior group, 2.60 ± 0.79 in inferior group; P value 0.712). The duration of follow-up after surgery was significantly more (P = 0.048) in the inferior CAU group (42.60 ± 11.71 days) as compared to the superior CAU group (37.39 ± 7.52 days). Postoperative symptoms were comparable, and no recurrence was observed in either of the two groups. CONCLUSIONS Pterygium excision with inferior conjunctival limbal autograft is safe and effective in the management of primary pterygia and may be considered as an alternative to superior graft in cases where harvesting the superior conjunctiva is not possible or not advisable. KEYWORDS Primary Pterygium, Conjunctival Limbal Autograft, Inferior Graft

A PROSPECTIVE ANALYSIS OF VISUAL ACUITY AND ASTIGMATIC CHANGES AFTER PTERYGIUM EXCISION WITH LIMBAL STEM CELL GRAFTING

2021 ◽  
pp. 21-23
Author(s):  
Kumari Preeti ◽  
Nitu Kumari ◽  
[Prof.] Alka Jha ◽  
Debarshi Jana
Keyword(s):  
Visual Acuity ◽  
Stem Cell ◽  
Corneal Astigmatism ◽  
Surgical Removal ◽  
Prospective Analysis ◽  
Cell Grafting ◽  
Induced Astigmatism ◽  
Pterygium Excision ◽  
Limbal Stem Cell ◽  
Primary Pterygium

Objectives: The aim of this study was to assess if there is any signicant reduction in astigmatism and thus improvement in visual acuity after pterygium excision with limbal stem cell grafting. Methods: In this prospective study, patients with primary pterygium were included. Preoperative and postoperative corneal astigmatism, refractive astigmatism and visual acuity were analyzed. All patients underwent pterygium excision with limbal stem cell grafting. Results: Mean improvement in visual acuity of 0.09 log MAR units was observed (p <0.0001, statistically signicant).Mean corneal astigmatism for grade I, II and III was found to be 1.03 ± 0.68D, 1.69 ± 0.80D and 2.90 ± 1.06D respectively. Mean corneal astigmatism decreased by 1.29 D (p <0.0001, statistically signicant).A decrease of 0.77D in cylindrical power required was found after surgery (p <0.0001, statistically signicant). Conclusions: there is a signicant reduction in pterygium induced astigmatism and improvement in visual acuity on surgical removal of the pterygium.

scholarly journals The Effect of Pterygium Surgery on Corneal Topography

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N M Welson ◽  
M M M Samy ◽  
A A Gaafar ◽  
T A Badran
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Corneal Topography ◽  
Surgical Removal ◽  
Significant Difference ◽  
Uncorrected Visual Acuity ◽  
Pterygium Surgery ◽  
The Mean ◽  
Pterygium Excision ◽  
Topographic Astigmatism

Abstract Objective To evaluate the effect of pterygium surgery on corneal topography by comparing wave front analysis before and one month after the surgical treatment. Methodology Fifty eyes of forty-one patients were included in this study. Twenty five male and sixteen female patients seeking pterygium surgery were recruited from the Ophthalmology Department Outpatient Clinic in Sohag Teaching Hospital during the period from July 2017 to May 2018. All eyes underwent pterygium excision with conjunctival autograft. Results In this study we found a highly statistically significant improvement in the mean uncorrected visual acuity from 0.44±0.21SD preoperatively to 0.62±0.18SD postoperatively (p &lt; 0.001) and a highly statistically significant difference in the mean logMAR visual acuity as it was decreased from 0.43±0.28 SD preoperatively to 0.34±0.23 SD postoperatively (p &lt; 0.001). Also, there was a highly statistically significant improvement in mean of manifest refractive astigmatism from -4.08±3.28 SD preoperatively to -1.46±1.40 SD postoperatively (p &lt; 0.001). We also found a highly statistically significant improvement in the mean cycloplegic astigmatism from -4.00±3.01 SD preoperatively to -1.39±1.33 SD postoperatively (p &lt; 0.001) and also there was a highly statistically significant improvement in the mean topographic astigmatism from -5.17±4.08 SD preoperatively to -2.20±2.31 SD postoperatively (p &lt; 0.001). We also found a highly statistically significant improvement in the mean of ISV (Index of Surface Variance) from 76.22±36.86 SD preoperatively to 33.56±15.02 SD post operatively (p &lt; 0.001) and also there was a highly statistically significant improvement in the mean IHD (Index of Height Decentration) from 0.042±0.027SD pre-operatively to 0.023±0.036 SD post operatively. Conclusion There was a highly statistically significant difference in the mean logMAR visual acuity and a highly statistically significant improvement in the mean uncorrected visual acuity. A highly statistically significant improvement in both refractive and topographic astigmatism after one month of the surgery was noted also. Here were also a highly statistically significant improvement in ISV and IHD that indicate improvement after pterygium removal. Recommendations Patient with pterygium that inducing astigmatism will benefit from surgical removal of the pterygium.

scholarly journals Comparison Of Conjunctival Autograft And Combined Amniotic Membrane Mini-Simple Limbal Epithelial Transplantion After Primary Pterygium Excision

2020 ◽  
Author(s):  
ASHOK JHA ◽  
Abhay Simba
Keyword(s):  
Fibrin Glue ◽  
Amniotic Membrane ◽  
Operative Time ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Conjunctival Autograft ◽  
Group I ◽  
Pterygium Excision ◽  
Group Ii ◽  
Primary Pterygium

Abstract Background: To compare conjunctival autograft and combined amniotic membrane mini-simple limbal epithelial transplant after primary pterygium excision Methods: A prospective randomized interventional study was conducted on 264 eyes with Primary Pterygium.The patients were divided into Group I (conjunctival autograft) and Group II (mini-simple limbal epithelial transplant). 133 eyes in Group I underwent pterygium excision with a conjunctival autograft using fibrin glue. 131 eyes in Group II underwent mini Simple Limbal Epithelial Transplant with amniotic membrane using fibrin glue. Post-operatively, the patients were reviewed on day 1,3,7,14 & 30 and then at three,six and nine months. Primary outcome measure was the recurrence rate whereas the secondary outcome measures were the intraoperative time and other complications.Recurrence rate was calculated using Fisher’s exact test. Variables like age , preoperative BCVA , operative time and the dimensions of graft were compared using unpaired t test . Other baseline characteristics like gender, Laterality, grades of pterygium(I-III),Occupation and indication of surgery were expressed between the two groups using Pearson’s Chi-Square test. Results: Two hundred and thirty three eyes(118 in group I and 115 in group II) could complete nine months follow-up period. Recurrence was seen in 2(1.6%) cases in group I whereas 3 cases (2.6%) had recurrence in group II(p=0.681).Operative time for group (II) (20.33±1.28 min) was significantly higher (p<0.001) than group I (12.01±1.26). Graft displacement occurred in one case in group II (p=0.999). Conclusions: Despite a longer time,(p<0.001) mini-SLET seems to be a viable and equally effective alternative to CAG in the management of primary pterygium ,especially in cases where conjunctiva needs to be spared.Ethical Clearance Certificate Number : 29/MH/2015 dated 11 Aug 2015

scholarly journals Randomized interventional trial comparing conjunctival autograft secured with Sutures versus fibrin glue in primary pterygium excision

2018 ◽  
Vol 3 (2) ◽  
pp. 1-7
Author(s):  
Dr. Keerthivarman Rukmangathan ◽  
◽  
Dr. Dhivya Ramakrishnan ◽  
Dr. Vasudarini Sundararajan ◽  
Dr. Ranjan Chandrasekaran ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Interventional Trial ◽  
Conjunctival Autograft ◽  
Pterygium Excision ◽  
Primary Pterygium

scholarly journals Efficacy of Submucosal Dexamethasone Injection on Postoperative Adverse Outcomes Following Third Molar Surgery

2021 ◽  
pp. 238-246
Author(s):  
Arfat Bashir ◽  
Samreen Naz ◽  
Marium Khalil ◽  
Mehmil Aslam ◽  
Fida Hussain ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Adverse Outcomes ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
The Third ◽  
Operative Outcomes ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean

Introduction: The most common dento-alveolar procedure is surgical removal of an impacted third molar, which is associated with post-operative pain, swelling, and trismus. Objective: To determine the effect of submucosal dexamethasone injection on the post-operative outcomes in third molar surgeries. Materials and Methods: It was a descriptive study conducted in Department of Oral & Maxillofacial Surgery, Liaquat College of Medicine & Dentistry, Karachi between November 7, 2019 to May 6, 2020. All patients who fulfilled the inclusion criteria and visited to LCMD, Karachi were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, all the patients (n=65) received 4mg submucosal dexamethasone injection. The duration of surgery was recorded with postoperative outcomes in terms of pain, trismus and swelling were measured on 3rd and 7th day. All the collected data were entered into the proforma and used electronically for research purpose. Results:  The mean SD of age was 25.9 ± 7.2 years. Right side surgery was documented in 39 (60%) patients, while left side surgery was documented in 26 (40%) patients. On the third and seventh day, the mean SD of VAS pain score was (5.9 ± 3.2), (3.8 ± 4.4), swelling was (2.5 ± 1.1), (0.9 ± 0.6) mm, and trismus was (16.9 ± 9.7), (11.8 ± 9.1) mm, respectively. Conclusion:  It is to be concluded that a significant difference in outcomes was observed between the third and seventh post-operative days in patients who had submucosal dexamethasone injections in third molar surgeries.

scholarly journals Effect of tissue glue versus suture in pterygium surgery in a tertiary care center of North-East India

2021 ◽  
Vol 9 (6) ◽  
pp. 1598
Author(s):  
Monalisa Deori ◽  
J. J. Kuli ◽  
Bharati D. Boruah
Keyword(s):  
Fibrin Glue ◽  
Tertiary Care ◽  
Operating Time ◽  
Care Hospital ◽  
Conjunctival Autograft ◽  
Tissue Glue ◽  
Suture Group ◽  
Pterygium Surgery ◽  
Limbal Conjunctival Autograft ◽  
Postoperative Discomfort

Background: Pterygium is a triangular fibrovascular tissue of conjunctiva encroaching on to the cornea. Currently, conjunctival autograft technique after excision is reported as the most suitable and safest method. The autograft transplantation can be done either with the help of suture or tissue adhesives. Objective of the study was to evaluate the effects of tissue glue versus suture in limbal conjunctival autograft transplantation among the patients undergoing pterygium excision.Methods: A prospective study was carried out in a tertiary eye care hospital. 60 patients with primary pterygium underwent limbal conjunctival autograft transplantation. They were enrolled into two groups, group-A (tissue glue, N=30) and group-B (suture group, N=30). Operative time, postoperative patient comfort and recurrence of pterygium were assessed. The patients were followed-up for 6 months.Results: The mean surgical time in fibrin glue group (23.56±2.80) was significantly less compared to suture (30.78±2.20) group with p<0.001. Postoperative discomfort in terms of pain, lacrimation and foreign body sensation was significantly less with fibrin glue in comparison to suture (p<0.05). Postoperative complications like redness, subconjunctival hemorrhage, graft edema and graft retraction were significantly more in suture group during late postoperative period. Recurrence of pterygium was noted in two patients (6.67%) in suture group and one patient in fibrin glue group (3.33%) which was not statistically significant (p>0.005).Conclusions: The use of fibrin glue for securing the limbal conjunctival autograft in pterygium surgery significantly reduces the operating time and postoperative discomfort.

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