Fibrin glue versus vicryl sutures for primary conjunctival closure in pterygium surgery: long-term results

PURPOSE: To compare the long-term results of conjunctival closure with fibrin adhesive or Vicryl sutures in pterygium surgery. METHODS: The study was performed in 81 patients (81 eyes) with primary nasal pterygium. Surgery in all patients consisted of the bare sclera technique combined with intraoperative administration of mitomycin C 0.02%. Patients were randomized to undergo conjunctival closure with a fibrin adhesive (Quixil) (n = 42) or Vicryl sutures (n = 39). Clinical assessment was performed on postoperative days 1, 3, 10, and 21 and thereafter at 3, 6, and 12 months. All patients completed a questionnaire at each follow-up visit grading pain, discomfort, and satisfaction with the procedure. The groups were compared for operative time, ocular signs and symptoms, overall satisfaction, and recurrence rate. RESULTS: Average operative time was 16 min in the fibrin-glue group and 28 minutes in the Vicryl-suture group (p < 0.05). Significantly less pain and discomfort were noted in the subjects treated with glue than in controls (p < 0.05). Satisfaction was significantly higher in the study group (p < 0.04). There were no complications during follow-up period in the glue-treated patients; one patient in the suture group had a medically treatable corneal dellen. At the end of follow-up, recurrent pterygium developed in five (11.9%) eyes of the fibrin-glue group and in three (7.7%) eyes of the Vicryl-suture group (p < 0.05). CONCLUSIONS: The use of fibrin glue in pterygium surgery significantly reduces operative time and patient pain compared with suturing. However, it may be associated with a higher recurrence rate.