Medical Research Group of Egypt, Cairo. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Ophthalmology Department, Faculty of Medicine, Zagazig University. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Medical Research Group of Egypt, Cairo. Egypt. Department of Ophthalmology and Micro-Technology, Yokohama City University, Yokohama. Japan. Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522. Egypt. Department of Ophthalmology and Micro-Technology, Yokohama City University, Yokohama. Japan.
OBJECTIVE To perform a systematic review and meta-analysis of randomized controlled trials comparing the efficacy and complications of autologous blood versus using fibrin glue and surgical sutures for conjunctival autograft fixation in primary pterygium surgery. DESIGN Systematic review with quantitative meta-analysis. METHODS Four authentic databases have been searched using relevant keywords. Eligible studies were obtained, and their data were extracted
into an online form. Analysis was done using Review Manager for windows. Dichotomous outcomes were reported as risk ratio, while continuous data were reported as mean difference. RESULTS Seven studies were included in the analysis. Most of included studies were of moderate quality according to Cochrane Risk of Bias assessment tool. There was no difference between the three techniques in recurrence rates (Risk Ratio (RR) 0.80, 95% CI [0.45 to 1.44], p= 0.46). Graft retraction and displacement were more profound in the autologous blood group vs fibrin glue and suture groups (RR 3.22, 95% CI [1.48 to7.02], p= 0.003) and (RR 5.27, 95% CI [2.24 to 12.38], p> 0.001) respectively. In terms of operative time, fibrin glue took shorter while suturing took longer time compared to blood coagulum (Mean Difference (MD) =1.57, 95% CI [0.90, 2.25], p> 0.00001) and (MD -20.47, 95% CI [-38.05 to -2.88], p =0.02). CONCLUSIONS Autologous blood for conjunctival autograft fixation in primary pterygium surgery was associated with lower graft stability than fibrin glue or sutures. However, it did not account for higher recurrence rates than the fibrin glue or sutures. Patient satisfaction and postoperative symptoms are relatively better in the blood coagulum group than the other techniques. The overall quality of evidence is low. Further well designed randomized controlled trials are still needed.
