Human amniotic membrane transplantation with fibrin glue in management of primary pterygia: a new tuck-in technique.

PURPOSE: To report the use of fibrin glue for attaching the human amniotic membrane graft with a tuck-in technique after primary pterygium excision.

METHODS: Twelve patients with primary pterygium (grade 2 or 3) underwent pterygium excision. The bare sclera was covered with an oversized human amniotic membrane graft by using fibrin glue for graft adherence. The edges of the graft were tucked underneath the adjacent free margin of conjunctiva on 3 sides. Various parameters such as operative time, patient's postoperative comfort, graft adherence, time of graft epithelialization, and recurrence of pterygium were assessed.

RESULTS: The amniotic membrane graft adhered successfully in 11 patients. Average surgical time was 15.5 minutes (range, 13-21 minutes). The postoperative period was generally comfortable. Epithelialization of the graft was rapid, occurring within 7 days in 11 eyes. In 1 patient, the graft was found dislodged partially on the first postoperative day. Eleven eyes showed no recurrence at the end of 1-year follow-up.

CONCLUSIONS: Use of fibrin glue for attaching human amniotic membrane graft in primary pterygium surgery is effective. It not only reduces the surgical time but also minimizes postoperative discomfort and complications.