Clinical Observation Of Applying Fibrin Glue In The Pterygium Excisions With Sutureless Amniotic Membrane Transplantation

Objective: To observe and investigate the clinical efficacy of fibrin glue for attaching human amniotic membrane after primary pterygium excision.Methods: 21 patients (26 eyes) with primary pterygium underwent pterygium excision with amniotic membrane transplantation. Patients were randomized to two groups: fibrin glue group and suture group. In fibrin glue group, 11 patients (13 eyes) underwent pterygium excision, and the bare sclera was covered with amniotic membrane using fibrin glue for graft adherence; while in suture group, 10 patients (13 eyes), after pterygium excision, the amniotic membrane grafts were attached to the sclera using 10-0 nylon sutures. All surgeries were performed by the same doctor and surgical time was recorded. Patients were followed up in six months and ocular signs and symptoms were recorded. The results were analyzed by statistic software of SPSS.Results: Average surgical time (13.6±3.5 min) in fibrin glue group was significantly less than suture group (22.3±5.2 min) (P <0.01). In 2 weeks after surgery (before sutures out), less regional symptoms, such as pain, foreign-body sensation, tearing, were observed in the suture group (P <0.01). There were no transplant losses or dislocations in both groups by the end of the follow-up. It was observed that human amniotic membrane was tightly attached to the scleral bed in fibrin glue group. Complete epithelialization occurred in fibrin glue group within one week, while that in suture group was delayed to 8-10 days. Effusion was found under amniotic membranes in 5 eyes of suture group. Grafs'healing in fibrin glue group was better and no regional scar observed, while scars were seen in suture group at different levels. No recurrence was observed in both groups at the end of 6-month follow-up.Conclusion: Our results showed that fibrin glue can replace of sutures for attaching human amniotic membrane graft in primary pterygium surgery. It not only significantly reduces the surgical time, minimizes postoperative discomfort, but also benefits in graft's healing and decrease regional scar, thus leads to cosmetic aim.