Comparison between Sutureless and Glue Free versus Sutured Limbal Conjunctival Autograft in Primary Pterygium Surgery

Abstract

Introduction: To compare and evaluate the safety and efficacy of two surgical techniques for the management of primary pterygium.
 Materials & Methods: The study included 176 eyes of 176 patients with primary pterygium. The mean age was 49 ± 12 years (range 24–74 years). Simple excision under local anesthesia was performed followed by closure of the bare sclera by suture less and glue free conjunctival autograft in 76 eyes of 76 patients (group 1), versus the conventional method of a sutured conjunctival autograft in 100 eyes of 100 patients (group 2).
 Results: The pterygium recurrence rate was 6% for group 1, 8% for group 2. Graft dehiscence occurred in 4 eyes out of 50 (8%) in group 1. Graft retraction occurred in 6 (12%) out of 50 eyes for group 1 versus 6 eyes (6%) in group 2. Pyogenic granuloma occurred in 3 (3%) eyes out of 100 in group 2. No other serious complications were noted. At the 3 week visit the overall patient satisfaction score was statistically significantly higher for group 1 (P < 0.002) compared to group 2. At 3 months postoperatively, the gain in uncorrected visual acuity (UCVA) ranged from 0.2 to 0.5 Log MAR in 10 eyes.
 Conclusion: Sutureless and glue free conjunctival autograft technique is easy, safe, effective, prevents potential adverse reactions encountered with the use of foreign materials. This technique has an acceptable pterygium recurrence rate that is comparable to conventional sutured conjunctival autograft for primary pterygium.
 Medicine Today 2018 Vol.31(1): 1-8

Sutureless Glue Free Versus Sutured Limbal Conjunctival Autografts in Primary Pterygium Surgery

“…Our study had lesser dehiscence than a study done by Elwan (2014) where 8% cases had graft dehiscence in the sutureless group. Its incidence was low in the sutureless group (1.3%) in a study done by Huda and Khaleque, (2019).…”

Evaluation of Sutureless Glueless Conjunctival Autograft in Pterygium Surgery

“…[6] Bare sclera excision is no more used nowadays as it has an unacceptably high recurrence rate ranging from 24% to as high as 89% and has become obsolete. [7] Postoperative beta irradiation to the bare sclera has been in use for decades and led to reduction in recurrence associated with bare sclera technique. However complications of beta irradiation limit its use.…”

Comparison of Autologous Blood Coagulum (ABC) and Suture at Recurrence Rate and Graft Stability of Postoperative Primary Pterygium Using Conjunctival Autograft: A Meta-Analysis From Randomized Controlled Trial

“…The study selection process is shown in Figure 1. RCTs were used in the nine studies [7], [14], [15], [16], [17], [18], [19], [20], [21] that matched the inclusion criteria. Table 1 lists the characteristics of the nine studies.…”

“…The risk of bias in each included study shown in Figure 2. All nine studies did randomization, but six studies [7], [14], [16], [17], [19], [20] have a low risk of bias in the "random sequence generation" parameter by elaborating the randomization method. Two studies [20], [21] did not explain the randomization method, and one study [18] had a high risk of bias assessment in this parameter.…”

“…Five studies [14], [16], [17], [19], [20] have a low risk of bias in the "allocation concealment" parameter. All of the included studies have an unclear risk of bias in the "blinding" parameters because the reviewers did not find the blinding statement in each study.…”