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Comparative Studies | Ophthalmology | India | Volume 14 Issue 2, February 2025 | Popularity: 6 / 10
Comparing the Efficacy of Autologus Blood Serum vs Fibrin Glue in Conjunctival Autograft for Pterygium Excision
Dr. Kaushal Kumar, Dr. Sonu Pant, Dr. Neha Jacob, Dr. Fatima Nishat, Dr. Harshita Dubey
Abstract: Background: Pterygium is a progressive condition where abnormal conjunctival tissue grows onto the cornea, often caused by UV exposure. It affects populations in tropical regions more frequently. Although early stages are asymptomatic, advanced pterygia can cause visual impairment and cosmetic concerns due to corneal involvement. Surgical removal is typically necessary, with techniques evolving from bare sclera excision (now obsolete due to high recurrence rates) to modern methods like conjunctival-limbal autografts. Recent advancements include using fibrin glue instead of sutures to secure grafts, reducing surgery time and postoperative discomfort. Comparisons between fibrin glue and autologous blood serum, a newer alternative, aim to evaluate operative outcomes, cost-effectiveness, and complication rates in pterygium surgery. Therefore, the purpose of this study is to compare the effectiveness of fibrin glue and autologous blood serum in conjunctival autograft in pterygium surgery. Material and method: This prospective experimental study was conducted on Grade II and III pterygium patients who attended Ophthalmology OPD in Rajarajeswari Medical College and Hospital in Bengaluru, India, over a period from August 2022 to February 2024. A total of 100 eligible patients were randomly divided into two groups of 50 participants each. Pre-operative assessments included comprehensive ocular evaluations, and all patients underwent pterygium excision followed by graft placement using either autologous blood serum (Group A) or fibrin glue (Group B). Post-operative follow-ups were conducted at specific intervals to monitor outcomes and complications. Data analysis was performed using IBM SPSS Version 21.0, employing descriptive statistics and appropriate statistical tests to compare results between the two groups. This study contributes valuable insights into optimizing surgical techniques for pterygium management, with implications for improving patient outcomes and reducing recurrence rates. Ethical clearance was obtained, ensuring adherence to ethical standards throughout the study. Results: For conjunctival autografts in pterygium surgery, the study contrasted fibrin glue with autologous blood serum. Key findings include a predominant patient age range of 41-60 years, with slightly more males than females in both groups. The left eye was most commonly affected, with all patients experiencing foreign body sensation pre-operatively. Visual impairment and cosmetic concerns were also noted. Operative times were longer with autologous blood serum (Group A) compared to fibrin glue (Group B). Post-operatively, more patients in Group B initially reported pain, though by one month, both groups showed resolution. Foreign body sensation followed a similar trend. Significantly, graft loss occurred more frequently in Group B (fibrin glue) than in Group A (autologous blood serum), with a notable difference in recurrence rates, although not statistically significant. Pre-operative and post-operative visual acuity improvements were observed in both groups, with no significant difference between them. These findings underscore the efficacy and comparative outcomes of using autologous blood serum versus fibrin glue in conjunctival autografts for pterygium surgery. Conclusion: Therefore, we draw the conclusion that although though the Autologous Blood Serum group's mean operating time was longer than the Fibrin Glue group's, there were less post-surgical complications in the group receiving autologous blood serum, with a statistically significant difference in the complication of graft loss. Therefore, conjunctival autograft combined with pterygium removal produces better outcomes. Conjunctival autograft fixation with autologous serum is a feasible and safe substitute for the fibrin glue method.
Keywords: pterygium surgery, autologous blood serum, fibrin glue, conjunctival autograft, ophthalmic surgery
Edition: Volume 14 Issue 2, February 2025
Pages: 204 - 211
DOI: https://www.doi.org/10.21275/SR25201162134
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