Abstract
Purpose: To evaluate the differences between superior and inferior conjunctival autografts with fibrin glue in management of primary pterygium as regard surgical difficulties, duration, recurrence, complications and stem cell density. Patients and methods: In a prospective one stage randomized controlled study, 36 patients with primary pterygium were included in the study and assigned into 2 groups. Group A received superior and group B received inferior conjunctival auto graft each group comprised 18 patients. All eyes were followed up at day 1 and 3 and at first week, first month, 3 month and finally 6 month post-operatively. All the intraoperative and postoperative data were analyzed. Results: 36 patients with pterygium were included in this study and 17 patients were males and 19 were females with average follow up period of 7.5 ± 0.6 months. Mean age was 52.5 ± 5.9 years and 46.2 ± 11.7 years respectively,the mean size of pterygium was 12.1 ± 3.4 mm2 11.3 ± 2.1 mm2 respectively . Mean size of the autograft was 26.9 ± 6.7 mm2, and 27 ± 5.6 mm2 respectively. The mean surgical time was 17.8 ± 2.0 minutes and 17.5 ± 2.4 minutes respectively. Mean follow up period was 7.4 ± 0.6 months and 7.6 ± 0.7 months respectively. There was one recurrent case in each group. No difference in stem cell density between 2 groups. Conclusions: Inferior autograft with fibrin glue has the same advantages as superior one as regard rate of recurrence and surgical time but superior to it as regard patient discomfort and saving superior conjunctiva sparing it for future glaucoma surgery if needed.
Highlights
Pterygium is a fibrovascular growth of the conjunctiva extending across the limbus to invade the cornea at a variable distance
Free conjunctival autograft which was first described by Kenyon et al shows a low recurrence rate of 5.3%
In this study we aim to evaluate the differences between superior and inferior conjunctival autografts using fibrin glue in surgical management of primary pterygium as regard recurrence rates, difficulties in the technique, surgical duration and complications
Summary
Pterygium is a fibrovascular growth of the conjunctiva extending across the limbus to invade the cornea at a variable distance. The exposure to ultraviolet rays is a presumed aetiology and it is more common in people in countries with hot cimate [1]. Surgical removal of the pterygium is the permenant treatment; recurrence is the main issue. Simple excision leads to high rates of recurrence which are reported to be as high as 89% [1]. Free conjunctival autograft which was first described by Kenyon et al shows a low recurrence rate of 5.3%. Many subsequent studies have found this surgical technique to be safe and effective in reducing the number of recurrences after pterygium surgery [2,3]
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