Comparison of Superior and Inferior Limbal Conjunctival Autograft Transplantation in Primary Pterygium Surgery: A Retrospective Analysis

Abstract

Introduction: Conjunctival autografting is the cornerstone of pterygium treatment. The most typical way to harvest the conjunctival graft is superior. Nonetheless, it is not always possible to harvest a graft from the superior bulbar conjunctiva, which could impact the functionality and result of a subsequent filtering procedure [1]. This study aims to compare the effectiveness of superior conjunctival autografting and inferior conjunctival autografting without using glue or sutures. Methods: This was a prospective observational study conducted in the Department of Ophthalmology, Pabna Medical College Hospital, Pabna, Bangladesh during the period from January 2019 to December 2020. In our study, we included 200 eyes of 198 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 200 cases were included in this case series. 100 of them underwent superior limbal conjunctival autograft transplantation (Group A) and 100 of them underwent inferior limbal conjunctival autograft transplantation (Group B). There was one eye with recurrence in both groups, which was not statistically significant; there were two eyes with graft dehiscence in group B and one eye with graft dehiscence in group A. Graft retraction was not statistically significant in 12 cases in group A and 10 cases in group B. The inferior conjunctival autografting techniques are great alternatives with similar results and no increased risk of serious problems in cases where the superior conjunctiva must be maintained. Conclusion: Our findings show that suture-less and glue-free superior or inferior limbal conjunctival autograft is safe, cost-efficient, and successful.