COMPARISON OF SUTURELESS, GLUE-LESS CONJUNCTIVAL AUTOGRAFT VERSUS SUTURED LIMBAL CONJUNCTIVAL AUTOGRAFT FOR PRIMARY PTERYGIUM
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i8.45065Keywords:
Pterygium surgery, Sutureless glue free conjunctival autograft, Conjunctival autograftAbstract
Objectives: The objective of the study was to compare and evaluate efficacy of two surgical techniques for the management of primary pterygium in terms of complications and post-operative signs and symptoms.
Methods: The study included 60 patients with primary pterygium. The mean age was 42±10 years (range 22–62 years). Simple excision under local anesthesia was performed followed by closure of the bare sclera by suture less and glue free conjunctival autograft in 30 patients (Group I), versus the conventional method of a sutured conjunctival autograft in 30 patients (Group II).
Results: At Visit 1, 6 patients (20%) of Group I had Graft edema in comparison to 5 patients (16.67%) in Group II. Subcutaneous hemorrhage was noted in 6 (20%) patients in both the groups. Graft retraction was noticed in 4 patients (13.33%) in Group I and in 2 patients (6.66%) in Group II. Graft dislodgement was observed in 1 patient (3.33%) in Group I. One (3.33%) case of recurrence was reported at 6 months in Group I whereas 2 (6.67%) cases were reported in Group II. One case of Granuloma was reported in Group II. There were significantly lower post-operative signs and symptoms in Group I as compared to Group II in the 1st post-operative week and the difference between the two groups was statistically significant (p<0.05) at visit 1 and visit 2. The satisfaction survey revealed higher overall satisfaction score for Group I as compared to Group II.
Conclusion: Sutureless technique may be considered as a viable alternative to sutured technique in terms of surgical outcomes. It scores better in terms of post-operative symptoms when compared to sutures.
Downloads
References
Young AL, Cao D, Chu WK, Ng TK, Yip YW, Jhanji V, et al. The evolving story of pterygium. Cornea 2018;37:S55-7.
Mohammed I. Treatment of pterygium. Ann Afr Med 2011;10:197-203.
Shahraki T, Arabi A, Feizi S. Pterygium: An update on pathophysiology, clinical features, and management. Ther Adv Ophthalmol 2021;13:251584142110201.
Singh SK. Pterygium: Epidemiology prevention and treatment. Community Eye Health 2017;30:S5-6.
McCarty CA, Fu CL, Taylor HR. Epidemiology of pterygium in Victoria, Australia. Br J Ophthalmol 2000;84:289-92.
Ishioka M, Shimmura S, Yagi Y, Tsubota K. Pterygium and dry eye. Ophthalmologica 2001;215:209-11.
Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 1997;115:1235-40.
Maheshwari S. Pterygium-induced corneal refractive changes. Ind J Ophthalmol 2007;55:383-6.
Tan CS, Lim TH, Koh WP, Liew GC, Hoh ST, Tan CC, et al. Epidemiology of pterygium on a tropical island in the Riau Archipelago. Eye (Lond) 2006;20:908-12.
Sandford-Smith J. Eye Diseases in Hot Climates. Amsterdam, Netherlands: Elsevier; 2014. p. 63-78.
Bahuva A, Rao SK. Current concepts in management of pterygium. Del Ophthalmol Soc 2015;25:78-84.
Fuest M, Mehta JS, Coroneo MT. New treatment options for pterygium. Exp Rev Ophthalmol 2017;12:193-6.
Mejía LF, Santamaría JP, Cuevas M, Córdoba A, Carvajal SA. Comparison of 4 techniques for limbal-conjunctival autograft fixation in primary pterygium surgery. Eu J Ophthalmol 2017;27:466-9.
Yan B, Peng L, Peng H, Zhou S, Chen B. Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: A randomized controlled trial. Cornea 2019;38:1351-7.
Wang X, Zhang Y, Zhou L, Wei R, Dong L. Comparison of fibrin glue and vicryl sutures in conjunctival autografting for pterygium surgery. Mol Vis 2017;23:275-85.
Chu WK, Choi HL, Bhat AK, Jhanji V. Pterygium: New insights. Eye (Lond) 2020;34:1047-50.
Thatte S, Dube AB, Sharma S. Efficacy of autologous serum in fixing conjunctival autografts of various sizes in different types and grades of pterygium. J Ophthalmic Vis Res 2019;14:136-43.
Elwan SA. Comparison between sutureless and glue free versus sutured limbal conjunctival autograft in primary pterygium surgery. Sau J Ophthalmol 2014;28:292-8.
Bhargava P, Kochar A, Joshi R. Pterygium excision followed by sutureless and glue free infero-temporal conjunctival autograft. Del Ophthalmol Soc 2019;30:32-5.
Das PJ, Kumar D, Goswami H, Dutta SK. Pterygium surgery with conjunctival autograft with sutures versus suture-less and glue-less: A prospective comparative study. Int J Ocul Oncol Oculoplasty 2019;5:194-200.
Malik KP, Goel R, Gupta A, Gupta S, Kamal S, Malik VK, et al. Efficacy of sutureless and glue free limbal conjunctival autograft for primary pterygium surgery. Nep J Ophthalmol 2012;4:230-5.
Foroutan A, Beigzadeh F, Ghaempanah MJ, Eshghi P, Amirizadeh N, Sianati H, et al. Efficacy of autologous fibrin glue for primary pterygium surgery with conjunctival autograft. J Cur Ophthalmol 2011;23:39-47.
Published
How to Cite
Issue
Section
Copyright (c) 2022 Mandeep Singh, Anand Aggarwal, Rajinder Singh, Chiman Lal, Indu Khosa, Divjot Kaur, Surmila Meena
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
