Tissue adhesive reduces pterygium recurrence after excision with conjunctival autografting

In patients undergoing primary pterygium excision with conjunctival autografting, use of a fibrin tissue adhesive (Tisseel VH Fibrin Sealant) to adhere the graft can improve long-term outcomes by lowering recurrence rates, according to the findings of a retrospective case series presented by investigators from the University of California-Irvine.

The study compared recurrence rates in 27 eyes that had surgery using the tissue adhesive and a comparator group of 20 eyes in which the conjunctival autograft was secured using 8-0 Vicryl. All surgeries were performed by a single surgeon and received the same corticosteroid regimen postoperatively. The patients were predominantly non-Hispanic whites, and the two study groups were well matched with respect to demographic features and pterygium size.

During a minimum follow-up of 6 months, the recurrence rate was significantly lower in the tissue adhesive group compared with the sutured group, 3.7% versus 20%, respectively. All recurrences occurred within the first 3 to 3.5 months after surgery, and the patients who developed a recurrence were younger on average than those who remained recurrence-free.

"Our study found a lower rate of recurrence in a patient population that was predominantly white and residing in southern California," said Marjan Farid, MD. "However, it is a retrospective review and relatively small. Further studies are needed in larger sample sizes and should look at effects of the tissue adhesive in various racial-ethnic groups as well as when used in combination with amniotic membrane transplants or mitomycin-C."