Autologous serum as an alternative to fibrin glue for conjunctival autograft fixation in sutureless pterygium surgery

Authors

  • Jannatul Ferdause Department of Ophthalmology, Mugda Medical College Hospital, Dhaka, Bangladesh
  • Mohammad Abdul Kadir Department of Medicine, Mugda Medical College Hospital, Dhaka, Bangladesh
  • Rifat Hasan Department of Transfusion Medicine, National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
  • Farhana Munmun Department of Transfusion Medicine, Green Life Hospital, Dhaka, Bangladesh
  • Sourav Das Department of Transfusion Medicine, National Centre for Control of Rheumatic Fever and Heart Diseases, Dhaka, Bangladesh
  • Umma Asma Saki Department of Transfusion Medicine, KPJ Specialized Hospital, Dhaka, Bangladesh
  • Anamul Haque Department of Medicine, Mugda Medical College Hospital, Dhaka, Bangladesh
  • Trishna Saha Department of Transfusion Medicine, National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20261327

Keywords:

Pterygium, Autologous serum, Fibrin glue, Conjunctival autograft, Recurrence

Abstract

Background: Pterygium is a common ultraviolet (UV)-related ocular surface disorder. Although conjunctival autografting lowers recurrence, the optimal graft fixation method remains debated. Autologous serum offers a cost-effective alternative to fibrin glue in sutureless pterygium surgery. Objectives were to compare the efficacy of autologous serum and fibrin glue for conjunctival autograft fixation in sutureless pterygium surgery.

Methods: This prospective randomized comparative interventional study was conducted at the Department of Ophthalmology, Dhaka Medical College Hospital, from January to July 2020. Sixty patients with primary nasal pterygium were randomly allocated into two groups: Group A (autologous serum) and group B (fibrin glue), with 30 patients in each group. Operative time, graft adherence, postoperative symptoms, complications, and recurrence at 3 months were evaluated. Data were analyzed using SPSS version 22, and p<0.05 was considered statistically significant.

Results: The mean surgical time was 23.11±1.69 minutes in group A and 24.41±1.19 minutes in group B (p=0.084). Complete graft adherence on the first postoperative day was observed in 96.7% of group A and 100% of group B. Postoperative symptoms were present in 50.0% and 60.0% of patients, respectively (p=0.463). Recurrence at 3 months occurred in 3.3% of group A and none in group B (p=1.000). No statistically significant differences were found between groups.

Conclusions: Autologous serum is a safe, effective, and economical alternative to fibrin glue for conjunctival autograft fixation in sutureless pterygium surgery.

References

Van Acker SI, Haagdorens M, Roelant E, Rozema J, Possemiers T, Van Gerwen V, et al. Pterygium Pathology: A Prospective Case‐Control Study on Tear Film Cytokine Levels. Mediators of inflammation. 2019;2019(1):9416262.

Bikbov MM, Zainullin RM, Kazakbaeva GM, Gilmanshin TR, Salavatova VF, Arslangareeva II, et al. Pterygium prevalence and its associations in a Russian population: the Ural eye and medical study. Am J Ophthalmol. 2019;205:27-34.

Clearfield E, Muthappan V, Wang X, Kuo IC. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016(2):CD011349.

Sharma A, Raj H, Raina AV. Sutureless and glue-free limbal conjunctival autografting following pterygium excision. JK Sci. 2015;17(2):68-70.

Ti SE, Chee SP, Dear KBG, Tan DTH. Analysis of variation in success rates in conjunctival autografting for primary and recurrent pterygium. Br J Ophthalmol. 2000;84(4):385-9.

Suzuki T, Sano Y, Kinoshita S. Conjunctival inflammation induces Langerhans cell migration into the cornea. Curr Eye Res. 2000;21(1):550-53.

Uy HS, Reyes JMG, Flores JD, Lim-Bon-Siong R. Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision. Ophthalmology. 2005;112(4):667-71.

Bhargava P, Kochar A, Joshi R. A novel technique-pterygium excision followed by sutureless and glue-free conjunctival autografting. Acta Med Sci. 2015;2:6-8.

Thatte S, Dube AB, Sharma S. Efficacy of autologous serum in fixing conjunctival autografts of various sizes in different types and grades of pterygium. J Ophthal Vision Res. 2019;14(2):136.

Röck T, Bramkamp M, Bartz-Schmidt KU, Röck D. A retrospective study to compare the recurrence rate after treatment of pterygium by conjunctival autograft, primary closure, and amniotic membrane transplantation. Med Sci Monitor. 2019;25:7976.

Malik KPS, Goel R, Gupta A, Gupta SK, Kamal S, Malik VK, et al. Efficacy of sutureless and glue-free limbal conjunctival autograft for primary pterygium surgery. Nepal J Ophthalmol. 2012;4(2):230-5.

Rangu RV, Wanjari A, Akhade N. Study of sutureless and glue-free conjunctival autograft. Int J Recent Trends Sci Technol. 2014;10:480-2.

Singh B, Babber M, Sami I, Gautam D. Outcome of the use of autologous blood serum, fibrin glue and vicryl suture in conjunctival autograft transplant following pterygium surgery. Int J Med Sci Clin Invent. 2020;7(6):4860-4.

Sharma K, Manjhi PK, Pandey ML. Comparative study to evaluate the outcome of sutures versus sutureless in attachment of conjunctival autograft for pterygium excision. Indian J Public Health Res Dev. 2020;11(2):773-8.

Kurian A, Reghunadhan I, Nair KG. Autologous blood versus fibrin glue for conjunctival autograft adherence in sutureless pterygium surgery: a randomised controlled trial. Brit J Ophthalmol. 2015;99(4):464-70.

Shrivastava S, Patkar P, Ramakrishnan R, Kanhere M, Riaz Z. Comparison of fibrin glue and autologous serum for conjunctival autograft fixation in pterygium. Delta J Ophthalmol. 2017;18(3):133-5.

Elwan SA. Comparison between sutureless and glue-free versus sutured limbal conjunctival autograft in primary pterygium surgery. Saudi J Ophthalmol. 2014;28(4):292-8.

Rafe A, Naeem S, Munawar T. Fibrin glue versus autologous serum for conjunctival autograft fixation in pterygium surgery. Pak J Ophthalmol. 2020;36(1):79-82.

Boucher S, Conlon R, Teja S, Teichman JC, Yeung S, Ziai S, et al. Fibrin glue versus autologous blood for conjunctival autograft fixation in pterygium surgery. Can J Ophthalmol. 2015;50(4):269-72.

Nadarajah G, Ratnalingam VH, Isa HM. Autologous blood versus fibrin glue in pterygium excision with conjunctival autograft surgery. Cornea. 2017;36(4):452-6.

Zein H, Ismail A, Abdelmongy M, Elsherif S, Hassanen A, Muhammad B, et al. Autologous blood for conjunctival autograft fixation in primary pterygium surgery: A systematic review and meta-analysis. Curr Pharmaceut Design. 2018;24(35):4197-204.

Massaoutis P, Khemka S, Ayliffe W. Clinical outcome study of a modified surgical technique for pterygium excision. Can J Ophthalmol. 2006;41(6):704-8.

Downloads

Published

2026-04-29

How to Cite

Ferdause, J., Kadir, M. A., Hasan, R., Munmun, F., Das, S., Saki, U. A., Haque, A., & Saha, T. (2026). Autologous serum as an alternative to fibrin glue for conjunctival autograft fixation in sutureless pterygium surgery. International Journal of Research in Medical Sciences, 14(5), 1916–1921. https://doi.org/10.18203/2320-6012.ijrms20261327

Issue

Section

Original Research Articles