The results of surgical treatment of pterygium using two-component autofibrin glue
Authors:   Kirov Military Medical Academy, Malafeeva A.Y. , Churashof S.V. ,   Kirov Military Medical Academy, Kulikov A.N. ,   Kirov Military Medical Academy, Nazarenko N.R. ,   Kirov Military Medical Academy, Gavrilyuk I.O. ,   Kirov Military Medical Academy
Published: October 2022

The only effective way to treat pterygium is to perform surgical intervention in various ways (without replacing the defect of the conjunctiva and replacing the defect with allogeneic or autologous tissues). One of the most effective methods is considered to be the removal of the pterygium with defect plasty with an amniotic membrane. The issue of choosing the fixation of the amniotic membrane is topical. The use of a suture fixation method is considered the gold standard, but this method increases the duration of the operation, and is also accompanied by discomfort for the patient in the postoperative period. The use of an adhesive fixation method using autologous fibrin adhesives is considered promising. Purpose of the study: to conduct a comparative analysis of the effectiveness of surgical treatment of pterygium using a two-component autofibrin glue and sutures for fixing the amniotic membrane. Material and methods. The study included 15 patients. All patients were divided into 2 groups depending on the method of fixing the amniotic membrane: the 1st group was the main group, where the amniotic membrane was fixed with a two-component autofibrin glue, the 2nd group was the control group, where the amniotic membrane was fixed with sutures. All patients underwent biomicroscopy and optical coherence tomography of the anterior segment to determine the stage of pterygium. Before surgical treatment, tear production was assessed using the Schirmer test. The study groups compared the time spent on the operation. After the surgical intervention, the control periods were followed by photo registration, optical coherence tomography of the anterior segment, as well as an assessment of the presence of the following "symptoms" in the patient: pain, sensation of a foreign body, itching, lacrimation, assessed in points on a visual analogue scale. After 6 months, the presence of pterygium recurrence in the study groups was assessed. Statistical analysis was carried out using the StatTech v. 2.8.8. Results. As a result of evaluating the indicator "Duration of surgery" depending on the study group, we found statistically significant differences (p = 0.032). When assessing the "Pain" indicator, statistically significant differences were detected on the 1st (p = 0.007), 3rd (p = 0.03) and 7th days (p = 0.047) after the operation. When assessing the indicators of the presence of "Foreign body sensation" and "Itching", statistically significant differences between the groups were detected only on the 1st day after the operation (p = 0.04 and p = 0.017, respectively), in the remaining control periods, differences between the groups were revealed did not have. When analyzing the indicator of "Lacrimation", no statistically significant differences between the studied groups were revealed for all control periods of the study. No recurrence of pterygium was recorded in any of the cases 6 months after the surgical interventions. Conclusion. Fixation of the amniotic membrane with the help of the developed two-component autofibrin glue during the surgical treatment of pterygium provides not only a reduction in the operation time, but also a more comfortable postoperative period. Keywords: pterygium, autofibrin glue, surgical treatment, amniotic membrane.