A comparative study of fibrin glue versus suturing on higher order aberration in patients undergoing pterygium excision and free conjunctival autograft

Abstract

The aim of this study is to comparation of fibrin glue versus suturing on higher order aberration in patients undergoing pterygium excision and free conjunctival autograft. Materials and Methods: In this study, which was performed as a clinical trial, the target population included patients referred to a Nikoukari hospital in 2018-19 for whom the diagnosis of pterygium was confirmed. Thirty-six patients with pterygium and indication for pterygium surgery were included in two groups of 18 patients. The first group underwent pterygium excision and conjunctivolimbal autograft using suture and the second group underwent pterygium excision and conjunctivolimbal autograft using Fibrin Glue. The sampling method was Systematic Random Sampling. Patients were divided into two groups as alternate. Patients' vision and abrometry of patients before and six months after surgery were measured using a Pentacum device under the same conditions and by one person. Results: There was no statistically significant difference between the two groups in terms of age and sex (P-value> 0.05). type of pterygium disease was fibrovascular in all subjects .The mean (standard deviation) of Vertical Pterygium in these two groups of patients was (4.75 ± 1.9) and (5.5 ± 0.8), respectively. Also, the mean (standard deviation) of Horizontal Pterygium in these two groups of patients was (4.11 ± 1.2) and (4.04 ± 0.1), respectively. Symptoms and signs immediately after surgery in the group of patients undergoing pterygium surgery and conjunctival autograft in the suture method: 7 cases (38.9%) of tears sheding and 16 cases (88.9%) of foreign body sensation and 1 case (5.6%) ) Was photophobic and 9 cases (0.50%) were pain. In the group under fibrin glue surgery, 3 cases (17.6%) shed tears, and 3 cases (17.6%) felt foreign body, and 4 cases (23.5%) photophobic and 10 cases (58.8%) was pain. early and late surgical complications in patients undergoing surgery by suture method were 1 case (5.6%) dehiscence, 1 case (5.6%) subgraft hemorrhage and 1 case (5.6%) chemosis. In the fibrin glue group, no case of dehiscence was observed, but 1 case (5.6%) was subgraft hemorrhage and 3 cases (17.6%) were chemosis. In this case study, only one case of recurrence (5.6%) was observed in the suture group. There was also a case of mild corneal scar after surgery in Suture group and one case in fibrin glue group. The presence of foreign body sensation symptoms in the group of suture method was significantly higher than fibrin glue method (P <0.001). UCVA increased in both groups of suture and fibrin glue 6 months after surgery (p = 0.001 and p = 0.00, respectively). Also BCVA In both groups of suture and fibrin glue , 6 months after surgery was increased compared to the time before surgery (p = 0.00). ) And 6 months after surgery (p = 0.503). there was no difference and in fact the use of fibrin glue instead of suture did not cause a further increase in visual acuity. The rate of keratometric astgmatism was decreased before and 6 months after surgery in both groups of suture and fibrin glue (P = 0.002 and P = 0.00, respectively). In terms of spherical equivalent refraction, the reduction was significant in the Suture group 6 months after surgery compared to before surgery (p = 0.015), while in the fibrin glue group this reduction was not statistically significant (p = 0.306). In terms of 0 degree trefoil in both groups of suture and fibrin glue was significantly reduced 6 months after surgery (p = 0.028 and p = 0.007, respectively). In 30-degree trefoil, a significant decrease was observed in both groups of suture and fibrin glue 6 months after surgery (p = 0.006 and p = 0.005, respectively). Zero-degree quatrefoil was statistically significant in both aberrations (p = 0.008 and p = 0.00, respectively) in both groups of suture and fibrin glue compared to before and 6 months after surgery. In Quatrefoil study of 22.5 degrees, a decrease in the rate of aberrations was observed in the period of 6 months after surgery in the fibrin adhesive group, which was statistically significant (p = 0.015), while in the Suture group, no significant decrease was observed. (p = 0.267).