Abstract
Aim: To evaluate the efficacy and complication of sutureless and glue-free conjunctival autograft for the management of primary pterygium over a period of one year.
 Methods: Prospective, interventional, hospital-based study. Twenty-four eyes of 24 patients with primary nasal pterygium were graded, and excision was performed by a single surgeon. To prevent recurrence, a free conjunctival autograft was taken from the superior quadrant from the same eye and the bare sclera was covered without the use of sutures or fibrin glue, allowing natural autologous coagulum of the recipient bed to act as a bioadhesive. The eye was patched for 24 hours. Postoperatively, patients were put on topical eye drops (polymixin 0.5%, neomycin 0.5%, and dexamethasone 1%) four times daily for four weeks, and oral antibiotics and methyl prednisolone 3x4 mg per day for 5 days. Patients were followed up postoperatively on day 1, 1 week, 6 weeks, 6 months, and 12 months. They were examined for haemorrhage, wound gape, graft shrinkage, granuloma, graft dehiscence, recurrence, or any other complication.
 Results: The mean age of the patients was 56.96 ± 11.51 years (range 35-81 years). There were 18 females (75%) and 6 males (25%). The following complications were noted: granuloma in three eyes (12.5 %), overriding graft onto the cornea in three eyes (4.17%), and recurrence in one eye (4.17%). No other complications were noted. Average surgical time was 16 ± 2 minutes. 
 Conclusion: Sutureless and glue-free limbal conjunctival autografting is a treatment modality for primary nasal pterygium with no additional cost and has only one recurrence case in 24 cases.
Highlights
Conjunctival autografting has been advocated for the management of recurrent pterygium
Suzuki et al reported that the use of silk or nylon sutures cause conjunctival inflammation and Langerhans cell migration into the cornea.[2]
Twenty-four eyes of 24 patients with primary nasal pterygium were graded, and excision was performed by a single surgeon
Summary
Conjunctival autografting has been advocated for the management of recurrent pterygium. The most common method of autograft fixation is suturing. It has its own drawbacks, such as increased operating time, postoperative discomfort, inflammation, buttonholes, necrosis, and giant papillary. Pterygium recurrences occur within the first six months after surgery. One such method to prevent recurrence is autologous limbal conjunctival grafting. Limbal conjunctival autograft transplantation re-establishes the barrier function of the limbus, and significantly lowers the recurrence rate. It is either attached with sutures or with biological adhesives such as fibrin glue, which is derived from pooled human plasma, or autologous fibrin. Suzuki et al reported that the use of silk or nylon sutures cause conjunctival inflammation and Langerhans cell migration into the cornea.[2]
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