If this is all that is done, the pterygium regrows frequently. The technique with the lowest recurrence rate uses an auto graft of conjunctiva from under the eyelid. This is placed over the defect remaining from the removed pterygium. The graft can be stitched in place, which is time-consuming, and painful for the patient afterwards. An alternative is the use of tissue adhesive fibrin glue (Tisseel or Full Link or Beriplast P or Quixil). A Cochrane Review including 14 studies and last updated October 2016, found that using fibrin glue when doing conjunctival autografting was associated with a reduced likelihood of the pterygium recurring compared with sutures. The review found that operations may take less time but fibrin glue may be associated with more complications (for example, rupture, shrinking and inflammation (granuloma). A 3-year clinical study on the application of ologen collagen matrix as excision site grafts showed significantly improved surgery success rates.The mechanism of the collagen matrix graft (commercially available as ologen®) works by promoting healthy cell growth into the matrix, thus preventing conjunctiva overgrowth that can cover the iris. References


== Further reading ==
Cytokine receptor-like factor 1 is a protein that in humans is encoded by the CRLF1 gene. Function
This gene encodes a member of the cytokine type I receptor family. The protein forms a secreted complex with cardiotrophin-like cytokine factor 1 and acts on cells expressing ciliary neurotrophic factor receptors. The complex can promote survival of neuronal cells. Clinical significance
Mutations in this gene are associated with two conditions, both rare:

Cold-induced sweating syndrome, characterized by profuse hyperhidrosis in cold environmental temperature and characteristic craniofacial and skeletal features)
Crisponi syndrome (CS), characterized by neonatal-onset paroxysmal muscular contractions, abnormal function of the autonomic nervous system and craniofacial and skeletal manifestations such as thick and arched eyebrows, a short nose with anteverted nostrils, full cheeks, an inverted upper lip and a small mouth.It is unknown whether the two conditions are distinct clinical entities or a single clinical entity with variable expressions. Other characteristic features in CRLF1 mutation include marfanoid habitus with progressive kyphoscoliosis and craniofacial characteristics including dolichocephaly, a slender face with poor expression, a nose with hypoplastic nares, malar hypoplasia and prognathism. References
Further reading
External links
GeneReviews/NCBI/NIH/UW entry on Cold-Induced Sweating Syndrome including Crisponi Syndrome
OMIM enries on Cold-Induced Sweating Syndrome including Crisponi Syndrome
Human CRLF1 genome location and CRLF1 gene details page  in the UCSC Genome Browser.This article incorporates text from the United States National Library of Medicine, which is in the public domain.