Comparison between fibrin glue and polyglactin sutures in limbal based conjunctival autograft technique in primary pterygium surgery in adults- A randomised controlled trial

Introduction: Pterygium is a slow growing, wing shaped, elastoticsubconjunctival degeneration within the palpebral fissure involving the cornea. As it encroaches the limbus, it proliferates as vascularised granulation tissue destroying the superficial stroma and Bowman’s membrane and is characterized by tissue remodelling, cellular proliferation, neovascularisation and inflammation. Objective: To compare between fibrin glue and polyglactin sutures in limbal based conjunctival autograft technique in primary pterygium surgery in terms of duration of surgery and early and late post-operative complications. Materials and Methods: It was a prospective comparative, randomized controlled trial which was conducted at North Bengal Medical College, Darjeeling, from July 2016 to June 2017. Patients with progressive pterygium diagnosed after proper clinical examinations and admitted for excision with conjunctival autograft attached with fibrin glue or for excision with conjunctival autograft sutured with 8-0 polyglactin. Data were collected and analysed. Results: 52 patients were randomly and equally divided into two groups, group A (fibrin glue) and group B (sutured with polyglactin) according to the type of surgery. In both the groups, there was female preponderance and the average age of the patients were 45.15 (5.576) and 40.65 (8.299) years respectively. Regarding the post-operative complications such as graft oedema (p= 0.002, c2 =10.035, df = 1), graft granuloma (p =.037, c2 = 4.333, df = 1) and recurrence (p = 0.638, c2 = 0.221, df = 1), the group A had less incidence than group B. The reduction of complications was statistically significant in group A in terms of graft oedema and graft granuloma but not in recurrence. Keywords: Conjunctivo-limbal autograft, Fibrin glue, Progressive pterygium.