Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis
Background Pterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis compared the modified sutureless glue-free (MSGF) method with...
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BMJ Publishing Group
2024-08-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/9/1/e001621.full |
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| author | Faisal Aljahdali Waleed Khayyat Abdulelah T BinYamin Sultan A Al-Qahtani Mohammed D Alghamdi Ali Saleh Alsudais Husain A Alalgum Halah Bin Helayel Mohammed AlMutlak |
| author_facet | Faisal Aljahdali Waleed Khayyat Abdulelah T BinYamin Sultan A Al-Qahtani Mohammed D Alghamdi Ali Saleh Alsudais Husain A Alalgum Halah Bin Helayel Mohammed AlMutlak |
| author_sort | Faisal Aljahdali |
| collection | DOAJ |
| description | Background Pterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis compared the modified sutureless glue-free (MSGF) method with conventional sutures (CS) for conjunctival autograft fixation in primary pterygium surgery.Methods A comprehensive search was conducted in MEDLINE, Embase, CENTRAL, Google Scholar and ClinicalTrials.gov for randomised controlled trials (RCTs) comparing MSGF and CS conjunctival autografts. Outcome measures included operation time, recurrence and postoperative complications. Standardised mean difference (SMD) and risk ratio (RR) were used for continuous and dichotomous outcomes, respectively.Results 11 RCTs involving 833 participants were included. The analysis revealed that MSGF had a significantly shorter operation time compared with CS (SMD −3.704, 95% CI −5.122 to −2.287, p<0.001). CS was associated with a higher risk of foreign body sensation (RR 0.22, 95% CI 0.06 to 0.74, p=0.01). MSGF was associated with a higher risk of graft dehiscence (RR 9.01, 95% CI 2.74 to 29.68, p=0.000) and graft retraction (RR 2.37, 95% CI 1.17 to 4.77, p=0.02). No significant differences were found in recurrence, graft haemorrhage, granuloma, Dellen and conjunctival oedema.Conclusion Using the MSGF technique in conjunctival autograft fixation for pterygium surgery reduces operation time by relying solely on the patient’s blood for fixation. However, it increases the risk of graft dehiscence and retraction. However, CS is linked to a higher likelihood of experiencing foreign body sensations. Understanding the learning curve and surgeon familiarity with novel techniques is crucial for optimising patient care and surgical outcomes, while individualised decision-making is necessary considering the advantages and disadvantages of each approach. Further research is warranted to minimise complications and optimise surgical outcomes. |
| format | Article |
| id | doaj-art-603c7a13061b4409abb2879aabbec35a |
| institution | Kabale University |
| issn | 2397-3269 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Ophthalmology |
| spelling | doaj-art-603c7a13061b4409abb2879aabbec35a2025-02-06T09:10:10ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692024-08-019110.1136/bmjophth-2023-001621Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysisFaisal Aljahdali0Waleed Khayyat1Abdulelah T BinYamin2Sultan A Al-Qahtani3Mohammed D Alghamdi4Ali Saleh Alsudais5Husain A Alalgum6Halah Bin Helayel7Mohammed AlMutlak8King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaKing Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaDepartment of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi ArabiaDepartment of Ophthalmology, King Abdulaziz University, Jeddah, Saudi ArabiaDepartment of ophthalmology, Ohud hospital, Al Madinah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaAnterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaAnterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaBackground Pterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis compared the modified sutureless glue-free (MSGF) method with conventional sutures (CS) for conjunctival autograft fixation in primary pterygium surgery.Methods A comprehensive search was conducted in MEDLINE, Embase, CENTRAL, Google Scholar and ClinicalTrials.gov for randomised controlled trials (RCTs) comparing MSGF and CS conjunctival autografts. Outcome measures included operation time, recurrence and postoperative complications. Standardised mean difference (SMD) and risk ratio (RR) were used for continuous and dichotomous outcomes, respectively.Results 11 RCTs involving 833 participants were included. The analysis revealed that MSGF had a significantly shorter operation time compared with CS (SMD −3.704, 95% CI −5.122 to −2.287, p<0.001). CS was associated with a higher risk of foreign body sensation (RR 0.22, 95% CI 0.06 to 0.74, p=0.01). MSGF was associated with a higher risk of graft dehiscence (RR 9.01, 95% CI 2.74 to 29.68, p=0.000) and graft retraction (RR 2.37, 95% CI 1.17 to 4.77, p=0.02). No significant differences were found in recurrence, graft haemorrhage, granuloma, Dellen and conjunctival oedema.Conclusion Using the MSGF technique in conjunctival autograft fixation for pterygium surgery reduces operation time by relying solely on the patient’s blood for fixation. However, it increases the risk of graft dehiscence and retraction. However, CS is linked to a higher likelihood of experiencing foreign body sensations. Understanding the learning curve and surgeon familiarity with novel techniques is crucial for optimising patient care and surgical outcomes, while individualised decision-making is necessary considering the advantages and disadvantages of each approach. Further research is warranted to minimise complications and optimise surgical outcomes.https://bmjophth.bmj.com/content/9/1/e001621.full |
| spellingShingle | Faisal Aljahdali Waleed Khayyat Abdulelah T BinYamin Sultan A Al-Qahtani Mohammed D Alghamdi Ali Saleh Alsudais Husain A Alalgum Halah Bin Helayel Mohammed AlMutlak Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis BMJ Open Ophthalmology |
| title | Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis |
| title_full | Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis |
| title_fullStr | Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis |
| title_full_unstemmed | Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis |
| title_short | Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis |
| title_sort | modified sutureless and glue free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery a systematic review and meta analysis |
| url | https://bmjophth.bmj.com/content/9/1/e001621.full |
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