Comparison of efficacy of three surgical methods of conjunctival autograft fixation in the treatment of pterygium

Abstract

Our aim primarily was to compare the recurrence rate with three techniques of conjunctival fixation (suture versus fibrin glue versus autologous in situ blood coagulum) over bare sclera following pterygium excision. Ninety eyes of 90 patients with primary pterygium were randomly divided into three groups: group I (30 eyes) underwent autografting and fixation with 8-0 vicryl sutures, group II (30 eyes) with fibrin glue and group III (30 eyes) with autologous in situ blood coagulum. The patients were reviewed on 2nd day, weeks 1 and 4, and at every 3 months till 12 months after surgery. Rate of recurrence was similar (p = 0.585) across the three groups. Time taken for surgery for Group 1 was more as compared to group 2 (p < 0.001) and group 3 (p < 0.001). Also, group 2 cases took significantly more time as compared to group 3 (p < 0.001). Postoperative patient discomfort (foreign body sensation, epiphora, pain and irritation) was more in suture-assisted autografting as compared to the other two groups. However, at some points along the time line, patient discomfort was significantly more in group III as compared to group II. Complications like graft retraction, graft displacement and cyst formation were seen in a few patients but were not statistically significant across the three groups. All three techniques were found to be useful methods and were associated with similar rate of recurrence.

Fibrin Glue Versus Autologous Serum for Conjunctival Autograft Fixation in Pterygium Surgery

“…Srinivasan et al, 19 in his study published in 2009 also found a higher recurrence rate with fibrin glue technique along with poor attachment, whereas Sati et al, 20 also conducted a similar study but reported contrary finding to our study and previous studies that graft loss and recurrence rate was similar in both techniques. He observed that the higher rate of graft rejection might be because of graft size rather than the technique of fixation.…”

Comparison Of Conjunctival Autograft And Combined Amniotic Membrane Mini-Simple Limbal Epithelial Transplantion After Primary Pterygium Excision

“…CAG can be xed to bare sclera either by sutures, brin glue or autologous in situ blood coagulum. Amongst the three techniques of xing CAG, brin glue de nitely offers the advantage of least operative time 19 . SLET was rst used for the treatment of stem cell de ciency by Sangwan and coworkers 20 .…”

Recurrence rate and corneal astigmatism after ‘sliding flap’ technique with intraoperative application of 0.05% mitomycin C or 20% ethanol for pterygium surgery

“…Pterygium excision with CAG or CLAG is the method of choice for most surgeons. The results of recent studies indicate on 3-10% recurrence rate after CAG procedure (27)(28)(29) but it may range up to 30% (for recent review see 30). The limbal conjunctival autograft procedure seems to be a little more effective than CAG with recurrence rate varies between 0 and 15% (for recent review see 30) but this process requires more experience.…”