The Use of Fibrin Glue in Pterygium Surgery with Amniotic Membrane Transplantation: Systematic Review and Meta-analysis

Overview

Journal Saudi J Ophthalmol

Specialty Ophthalmology

Date 2023 Jul 26

PMID 37492203

Authors

Mohammad Karam

Abdulmalik Alsaif

Ahmed Aldubaikhi

Meshaal Aljebreen

Rand Alazaz

Tariq Almudhaiyan

Abdullah Albaghli

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the outcomes of fibrin glue versus sutures in pterygium surgery with amniotic membrane transplantation.

Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses Guidelines. An electronic search identified all studies comparing the outcomes of using fibrin glue versus sutures in pterygium surgery with amniotic membrane transplantation. Conjunctival inflammation, postoperative pain and discomfort, pterygium recurrence, pyogenic granuloma, and surgical time were primary outcome measures. Secondary outcome measures included amniotic membrane transplant outcomes, time to recurrence, graft loss, and subconjunctival hemorrhage. Fixed and random-effects models were used for the analysis.

Results: Four studies enrolling 180 patients were identified. Conjunctival inflammation (odds ratio [OR] 0.21, = 0.0005) demonstrated a significant difference favoring the fibrin glue group. Despite the trend favoring the use of fibrin glue, there were no significant differences in terms of postoperative pain and discomfort (OR = 0.46, = 0.25), pterygium recurrence (OR = 0.74, = 0.48), pyogenic granuloma (OR = 0.47, = 0.38), and surgical time (mean difference = -17.52, = 0.13). For secondary outcomes, fibrin glue had significantly fewer cases of graft loss compared with sutures. No statistically significant difference was found in amniotic membrane graft outcomes, time to recurrence, and subconjunctival hemorrhage.

Conclusion: Fibrin glue is comparable to the sutures used in pterygium surgery with amniotic membrane transplantation as it significantly improves conjunctival inflammation and does not increase postoperative pain and discomfort, pterygium recurrence, pyogenic granuloma, and surgical time.

References

Jiang J, Yang Y, Zhang M, Fu X, Bao X, Yao K . Comparison of fibrin sealant and sutures for conjunctival autograft fixation in pterygium surgery: one-year follow-up. Ophthalmologica. 2008; 222(2):105-11. DOI: 10.1159/000112627. View

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151(4):264-9, W64. DOI: 10.7326/0003-4819-151-4-200908180-00135. View

Ozdamar Y, Mutevelli S, Han U, Ileri D, Onal B, Ilhan O . A comparative study of tissue glue and vicryl suture for closing limbal-conjunctival autografts and histologic evaluation after pterygium excision. Cornea. 2008; 27(5):552-8. DOI: 10.1097/ICO.0b013e318165b16d. View

Kheirkhah A, Casas V, Sheha H, Raju V, Tseng S . Role of conjunctival inflammation in surgical outcome after amniotic membrane transplantation with or without fibrin glue for pterygium. Cornea. 2008; 27(1):56-63. DOI: 10.1097/ICO.0b013e31815873da. View

Katbaab A, Anvari Ardekani H, Khoshniyat H, Jahadi Hosseini H . Amniotic membrane transplantation for primary pterygium surgery. J Ophthalmic Vis Res. 2013; 3(1):23-7. PMC: 3589214. View

Bahar I, Weinberger D, Dan G, Avisar R . Pterygium surgery: fibrin glue versus Vicryl sutures for conjunctival closure. Cornea. 2006; 25(10):1168-72. DOI: 10.1097/01.ico.0000240087.32922.ee. View

Suzuki T, Sano Y, Kinoshita S . Conjunctival inflammation induces Langerhans cell migration into the cornea. Curr Eye Res. 2000; 21(1):550-3. View

Nguyen L, Wang Z, Molina J, Tellez A, Chemoriya T . Complications of fibrin glue in pterygium surgery with amniotic membrane transplant. Eye Sci. 2012; 27(1):19-24. DOI: 10.3969/j.issn.1000-4432.2012.01.004. View

Pan H, Zhong J, Jing C . Comparison of fibrin glue versus suture for conjunctival autografting in pterygium surgery: a meta-analysis. Ophthalmology. 2011; 118(6):1049-54. DOI: 10.1016/j.ophtha.2010.10.033. View

10.

Kucukerdonmez C, Karalezli A, Akova Y, Borazan M . Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial. Eye (Lond). 2009; 24(4):558-66. DOI: 10.1038/eye.2009.136. View

11.

Romano V, Cruciani M, Conti L, Fontana L . Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery. Cochrane Database Syst Rev. 2016; 12:CD011308. PMC: 6463968. DOI: 10.1002/14651858.CD011308.pub2. View

12.

Gomes J, Romano A, Santos M, Dua H . Amniotic membrane use in ophthalmology. Curr Opin Ophthalmol. 2005; 16(4):233-40. DOI: 10.1097/01.icu.0000172827.31985.3a. View

13.

Ti S, Tseng S . Management of primary and recurrent pterygium using amniotic membrane transplantation. Curr Opin Ophthalmol. 2002; 13(4):204-12. DOI: 10.1097/00055735-200208000-00003. View

14.

Uy H, Reyes J, Flores J, Lim-Bon-Siong R . Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision. Ophthalmology. 2005; 112(4):667-71. DOI: 10.1016/j.ophtha.2004.08.028. View

15.

Mahdy R, Wagieh M . Safety and efficacy of fibrin glue versus vicryl sutures in recurrent pterygium with amniotic membrane grafting. Ophthalmic Res. 2011; 47(1):23-6. DOI: 10.1159/000328629. View

16.

Tseng S, Espana E, Kawakita T, Di Pascuale M, Li W, He H . How does amniotic membrane work?. Ocul Surf. 2007; 2(3):177-87. DOI: 10.1016/s1542-0124(12)70059-9. View

17.

Srinivasan S, Dollin M, McAllum P, Berger Y, Rootman D, Slomovic A . Fibrin glue versus sutures for attaching the conjunctival autograft in pterygium surgery: a prospective observer masked clinical trial. Br J Ophthalmol. 2008; 93(2):215-8. DOI: 10.1136/bjo.2008.145516. View