J Korean Ophthalmol Soc.  2017 Jul;58(7):797-803. 10.3341/jkos.2017.58.7.797.

Clinical Outcomes after Use of Fibrin Glue Using a Modified Mini-flap Technique for Pterygium Surgery

• Kim MK
• Jun I
• Kim TI
• Kim EK
• Seo KY

• KMID: 2387153
• DOI: http://doi.org/10.3341/jkos.2017.58.7.797

Abstract

PURPOSE
To analyze the long-term clinical outcomes after use of fibrin glue using a modified mini-flap technique for pterygium surgery.
METHODS
This study is a retrospective, clinical outcome study of 148 subjects that underwent the modified mini-flap technique with fibrin glue from January 2014 to August 2015. We analyzed the recurrence rate and surgical time of modified mini-flap surgery with fibrin glue. We also analyzed associating factors between the recurrence group and non-recurrence group who underwent the same surgery technique.
RESULTS
Mean age was 60.2 ± 1.1 (ranging from 29 to 86) years, and mean surgical time was 11.8 ± 5.8 (ranging from 5 to 36) minutes. The recurrence rate of pterygium patients who underwent the fibrin glue using a modified mini-flap technique was 4.0% (6/148), and the re-operation rate was 0.6% (1/148). From the comparison of associating factors between recurred and non-recurred groups, the recurred group was younger, had more severe disease, and had a higher rate of bilaterality than the non-recurred group (p < 0.05).
CONCLUSIONS
The new approach using fibrin glue with a modified mini-flap technique shows a low recurrence rate compared to the other type of pterygium surgery. The use of fibrin glue shortened operation time and decreased patient discomfort due to fewer remnant sutures. Fibrin glue use in a modified mini-flap technique can be considered as a feasible surgical option for pterygium patients.

Keyword

Fibrin glue; Mini-flap; Pterygium; Recurrence

MeSH Terms

Fibrin Tissue Adhesive*
Fibrin*
Humans
Operative Time
Outcome Assessment (Health Care)
Pterygium*
Recurrence
Retrospective Studies
Sutures
Fibrin
Fibrin Tissue Adhesive

Figure

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  Figure 1. Modified mini-flap technique with Fibrin glue. (A) Create conjunctival window on pterygium neck. (B) Remove ptery-gium from head to body. (C) Conjunctival relaxing incision for preparing a flap. (D) A conjunctiva-sclera-conjunctiva suture at 0.4 mm apart from corneolimbal margin. (E) A conjunctiva-sclera-conjunctiva suture at inner-most part of a conjunctival flap (black-ar-row). (F) Apply fibrinogen (black-arrow) under conjunctival flap and thrombin (white-arrow) above conjunctival flap. (G) Additional multiple conjunctival sutures (black-arrows) in Mini-flap technique without Fibrin glue.

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  Figure 2. Representative pre and post operative pictures of Fibrin glue using modified Mini-Flap technique for pterygium surgery. (A) Preoperative in patient received fibrin glue using modified mini-flap technique. (B) Postoperative 1 day in patient received fibrin glue using modified mini-flap technique. (C) Preoperative in severe pterygium case patient received fibrin glue using modified mini-flap technique. (D) Postoperative 1 month in severe pterygium case patient received fibrin glue using modified mini-flap technique.

Reference

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