CONJUNGTIVAL AUTOGRAFT TECHNIQUE WITH FIBRIN GLUE IN PTERYGIUM SURGERY

1. Agus Supartoto
2. Mandiri Nindiasari

Department of Ophthalmology, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital,Yogyakarta, Indonesia

Purpose: To evaluate the benefits of fibrin glue for attaching conjungtival autograft in pterygium surgery.

Methods: A prospective clinical trial at Dr.YAP Eye Hospital, on January to October 2010. This study was carried out in 38 eyes from 38 patients, consisted of 19 men and 19 women, age range between 28-71 years old (average 46.03±8.57). Twenty-six eyes were operated for primary nasal pterygium and 12 for secondary nasal pterygium. Autologous conjungtival graft at the superior limbal was used to cover the sclera after pterygium excision with a fibrin tissue adhesive (Beriplast-P) after MMC application. Surgical time was noted from the first injection of anesthetic liquid until application of the eye ointment. Photographs were taken in each follow-up. The complications and objective signs, were noted.

Results: Average overall surgical time was 17.50±5.0 minutes (range: 8.5-34 minutes), 17.06±5.52 minutes in primary group and 18.47±3.69 minutes in secondary group. Conjungtival autografts were successfully attached in all eyes (100%). There were granuloma formation of the donor site on 3 eyes (7.9%) and simblepharon formation on 1 eye (2.6%) as surgical complications. During the follow-up on month three, recurrence on 1 eye (2.6%) was found in secondary group, but none in primary group.

Conclusion: The use of fibrin glue for attaching conjunctival autograft in pterygium surgery, is a safe and effective tool to attach conjunctival autograft in pterygium surgery.