Management of recurrent pterygium with intraoperative mitomycin C and conjunctival autograft with fibrin glue

Abstract

Purpose: To evaluate the safety and efficacy of using fibrin glue in cases of recurrent pterygium treated with pterygium excision and conjunctival autograft combined with mitomycin C. Design: Retrospective, interventional case series. Methods: The charts of 28 patients with recurrent pterygium who had undergone pterygium excision and conjunctival autograft using fibrin glue to secure the graft combined with intraoperative mitomycin C at a corneal service in a university teaching hospital were reviewed. Inclusion criteria were recurrent pterygium that had undergone at least 1 previous surgical excision and patients who had completed a regular postoperative follow-up of at least 12 months. Outcome measures included mean best-corrected visual acuity (BCVA) and intraoperative and postoperative complications. Results: The mean age of the cohort was 49.7 years. There were no intraoperative complications. Early postoperative total graft dehiscence developed in 1 eye that underwent repositioning with glue and sutures. One eye had mild graft dehiscence and required no surgical intervention. One eye had a conjunctival cyst on the graft that did not require intervention. No significant change was observed in BCVA. At a mean follow-up of 26.5 months, there was 1 case of recurrence. Conclusions: Pterygium excision and conjunctival autograft using fibrin glue to secure the graft combined with intraoperative mitomycin C seems to be a safe and effective surgical option for treating recurrent pterygium. However, a larger cohort with longer follow-up may be required to assess the recurrence rate of this method. © 2011 Elsevier Inc. All rights reserved.