Pterygium excision with suture free, glue free conjunctival autograft: is it the ideal procedure for primary pterygium

Abstract

To study the complications with pterygium excision and conjunctival limbal autograft with patient’s own blood used as adhesive for graft. A prospective, cross sectional, timebound study including 52 patients with primary pterygium. Pterygium autograft was pasted over recipient bed using patients own blood without using sutures or fibrin glue. A 0.5 mm oversize graft was held in place for 5 minutes using blood at the pterygium excised site as adhesive. Post operatively after 24 hours, the eye was assessed under slitlamp for graft adherence, symptoms or any other complications and were advised topical moxifloxacin, loteprednol and lubricating eye drops. Patients were followed up on 7 day, 1 month and 4 month. Out of 52 patients there were 30 males and 22 females with highest incidence among 35 to 55 years age group (78.85%). Majority of patients had grade 2 (76.9%) pterygium and most of them were farmers by occupation while most common indications for surgery were visual problems (48.07%) and cosmetic (40.38%) reasons. Conjunctival autograft remained in place in 49 patients. In 3 patients there was mild graft dehiscence, 1 patient had pyogenic granuloma which needed resurgery. Graft related complications can be reduced by meticulous dissection, accurate orientation of graft and ensuring holding onto the graft placement area for at least 5 minutes for adherence.