Evaluation of the efficacy of autologous cryoprecipitate for attaching conjunctival autograft after primary pterygium excision

Abstract

Purpose The aim of this study was to evaluate the long-term safety and efficacy of using autologous cryoprecipitate for attaching conjunctival autograft and to compare the results of such technique with the use of vicryl sutures in patients undergoing primary pterygium excision, in terms of surgical time, postoperative patient comfort, visual acuity, complications, and recurrence rate. Patients and methods This is a prospective, interventional, comparative clinical study. It included 200 patients with primary nasal pterygium for whom surgical excision of the pterygium with conjunctival autograft obtained from the same eye was performed. The patients were divided into two groups: autologous cryoprecipitate was used in 100 patients (glue group) and absorbable sutures (8/0 vicryl sutures) were used in 100 patients (suture group) to attach the free conjunctival graft. The main outcome measures included operative time, postoperative pain, lacrimation, foreign body sensation, recurrence rate, and complications. The follow-up period was 24 months. Results The mean operative time was 20.28±2.73 min in the glue group and 31.04±6.52 min in the suture group, with a statistically significant difference (P<0.05). At the first postoperative day, pain, foreign body sensation, and lacrimation were reported by all patients in the suture group, whereas in the glue group, pain was reported in all patients, foreign body sensation was reported in 40 patients, and lacrimation was reported in 70 patients, with a statistically significant difference between the two groups (P<0.001). Pain and foreign body sensation persisted beyond the first week in 44 patients in the suture group and in only five patients in the glue group, with a statistically significant difference (P<0.001). Postoperative subconjunctival hemorrhage was reported in five patients in the glue group and in 15 patients in the suture group, with a statistically significant difference (P<0.05). Recurrence occurred in three patients in the glue group and in 12 patients in the suture group, which was statistically significantly lower in the glue group (P<0.05). Conclusion Using autologous cryoprecipitate for attaching conjunctival autograft in primary pterygium surgery resulted in shorter operative time and less postoperative pain, foreign body sensation, lacrimation, and subconjunctival hemorrhage. In addition, it decreased the recurrence rate. The cryoprecipitate method appeared to be effective, reliable, and safe after long-term follow-up.

Keywords

• autologous cryoprecipitate
• conjunctival autograft
• primary pterygium excision