A comparative study on the use of fibrin glue versus sutures in pterygium surgery with conjunctivolimbal autograft and its impact on higher-order aberrations

Pterygium is an ocular surface disease with different surgical treatment options, including conjunctival–limbal autograft. In this study, we aimed to compare the effect of pterygium surgery using suture versus fibrin glue.

In this clinical trial study, candidates for surgery were divided into two groups undergoing pterygium excision and conjunctival–limbal autograft, under the same conditions and by the same surgeon, using either suture or fibrin glue.

In total, 36 patients (18 in each group) participated in this study. There was no significant difference between the groups in demographic characteristics or in the size of the pterygium. The presence of symptoms of foreign body sensation was significantly lower in the fibrin glue group (p < 0.001). There was no significant difference between the groups in terms of tearing, photophobia, pain, surgery complications, and recurrence rate. No statistically significant difference was found between groups when comparing uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), keratometric astigmatism, and spherical equivalent refraction 6 months after surgery (p = 0.66, p = 0.503, p = 0.207, p = 0.351, respectively). A decrease of 0‑ and 90-degree coma after surgery was statistically significant in the fibrin glue group but not in the suture group.

The effectiveness of pterygium surgery and conjunctival–limbal autograft is the same with both suture and fibrin glue. Due to the high cost and lack of access to fibrin glue in developing countries, using the suture method as a tissue adhesive seems to be acceptable.