Biological glue in pterygium surgery with a rotational flap or sliding flaps

Purpose: To compare 2 surgical approaches to conjunctival flap placement during pterygium surgery using a biologic adhesive: single rotational flap and double sliding flaps. Methods: Thirty-three consecutive patients (34 eyes) with primary pterygium were assigned prospectively and randomly to receive pterygium surgery with either I rotational flap (group A, 19 eyes) or double sliding flaps (group B, 15 eyes) by using a biologic adhesive to secure the flaps. The patients were followed for 24 weeks. Results: In group A, 1 (5.3%) flap was lost because of ischemia, whereas all the others remained in position and became fully integrated. In group B, 4 (26%) flaps did not retain their primary position. In 2 (13%) eyes, the superior and interior flaps partially dehisced, resulting in a 2- to 3-mm gap, in 1 (6.5%) eye, the inferior flap dehisced completely and retracted to the lower fornix; and in 1 (6.5%) eye, both flaps completely dehisced and retracted, leaving an area of bare sclera. Conclusions: The use Of tissue adhesive is a promising technique in pterygium surgery. fit this study, gluing I rotational flap resulted in excellent postoperative results, but it seemed less suitable for use with double sliding flaps.