Pterygium Area Research Articles

Importance of Higher-Order Aberrations on Both Anterior and Posterior Surfaces After Pterygium Surgery.

The purpose of this study was to investigate the changes in higher-order aberrations (HOAs), coma, and spherical aberrations (SAs) on the anterior, posterior, and total corneal surfaces after pterygium excision. In this single-center study, we examined 19 eyes of 15 patients who underwent pterygium excision at Yokohama Minami Kyosai Hospital between January 2017 and December 2017. We also evaluated 25 eyes of 25 age-matched patients with no history of ocular disease as the control group. Corneal topography, total HOAs, coma, and SAs in all regions at 4 and 6 mm diameters were evaluated using anterior segment optical coherence tomography (CASIA SS-1000, Tomey, Japan). The pterygium area and extent were also assessed. Significant improvements in the HOAs, coma, and SAs at both diameters were observed in the total and anterior corneas from the first postoperative month. Notably, the posterior cornea showed significant improvements in HOAs (4 mm: P < 0.001 [log HOAs]; 6 mm: P = 0.001 [log HOAs]) and coma (4 mm: P = 0.003 [log coma], 6 mm: P = 0.002 [log coma]) within both diameters at 1 month postoperatively. A strong correlation was identified among the pterygium area, posterior HOAs, and coma (Spearman correlation = 0.651). Pterygium induced 2 D of astigmatism when extension exceeded 2.1 mm. HOAs in both the anterior and posterior corneas improved after pterygium excision. This finding underscores the importance of considering corneal aberrations on both anterior and posterior surfaces in pterygium management.

Correlation of Pterygium Induced Severity of Dry Eye Disease with Total Surface area of Pterygium

Correlation of Pterygium Induced Severity of Dry Eye Disease with Total Surface area of Pterygium

Conjunctival Autograft with Mitomycin C (MMC) in Primary Pterygium Excision

Purpose: To evaluate role of conjunctival Autograft (CAG) with Mitomycin C (MMC) in primary pterygium excision. Place and Duration of Study: Mughal eye hospital Lahore from 2020 to 2022. Methods: Patients with primary pterygium were operated. Pterygium excision was followed by Mitomycin C (MMC) 0.02% application for 2 minutes under the conjunctiva at base of the pterygium and this was followed by CAG. Patients were followed up at 1 week, 1 month and 2 months to see recurrence and any side effects of MMC. Google sheets were used for recording data of pterygia. Results: A total of 385 eyes of 316 patients with primary pterygium were included in the study. There were 209 males and 107 females. Mean age was 35 years (range 26 to 58 years). Follow up ranged from one month to 2 months. Four eyes (1%) had recurrence. It was noted that blood vessels of recurrent pterygium grew above or below the conjunctival graft on the side which was short. No complication of MMC was observed. There were 2 cases of graft dehiscence due to early breakdown of sutures. Conclusion: Recurrence after pterygium excision can be reduced to minimum by application of MMC with CAG and it is a safe procedure. Recurrence mostly encroaches on the cornea from above or below the conjunctival graft. A large conjunctival graft is thus necessary to cover the pterygium area and prevent recurrence. MMC is safe. Suturing the conjunctival graft provides minimum chances of graft loss.

Accurate detection and grading of pterygium through smartphone by a fusion training model

Background/aimsTo improve the accuracy of pterygium screening and detection through smartphones, we established a fusion training model by blending a large number of slit-lamp image data with a small proportion...

Atypical Presentation of Recurrent Pterygium Leading to Blindness and its Successful Management: A Series of Three Cases

Recurrence of pterygium is one of the main concerns in pterygium management. Recurrent pterygium is defined as the regrowth of fibrovascular tissue over the previously excised primary pterygium area, extending beyond the limbus and advancing towards the cornea. In most cases, it is characterised by increased conjunctival inflammation, fibroblast proliferation, and a faster progression towards corneal involvement compared to primary pterygium. This rapid regrowth can lead to irregular astigmatism, symblepharon, corneal fibrosis, severe vision impairment, and rarely, blindness. Incomplete removal of the primary pterygium, excessive suturing, the bare sclera technique, smaller conjunctival grafts, thicker conjunctival grafts with Tenon’s capsule, and poor control of postoperative inflammation are some of the most common surgical factors contributing to recurrence. Among all surgical procedures, the bare sclera technique has the highest recurrence rate. In the present case series, the author presented three cases of atypical recurrent pterygium and their successful management. The first case involved recurrent double-headed pterygium with severe symblepharon, resulting in lower fornix obliteration, shortening, diplopia, and corneal neovascularisation. The second case featured Grade-IV pterygium covering the pupillary area, and the third case involved a kissing type of doubleheaded pterygium. These cases were complications of the bare sclera technique, leading to blindness. Successful treatment of recurrent pterygium can improve visual and cosmetic outcomes. This case series aimed to highlight the burden and consequences of recurrent pterygium as a cause of avoidable blindness.

Decreased Macular Retinal Thickness in Patients With Pterygium

PurposeTo explore alterations in macular retinal thickness (RT) and analyze correlation between macular RT and pterygium area, length in pterygium patients.MethodsTotally 13 patients with pterygium (left eye) and 13 healthy controls (left eye) were recruited. OCTA was applied to scan each eye to generate three-dimensional images. Based on the Early Treatment Diabetic Retinopathy Study (ETDRS) method, each image was divided into nine subregions for the ETDRS: central (C); inner superior (IS); outer superior (OS); inner nasal (IN); outer nasal (ON); inner inferior (II); outer inferior (OI); inner temporal (IT); and outer temporal (OT). The macular RT in each subregion was measured. Furthermore, the correlation between RT and the area, length of pterygium was analyzed.ResultsThe visual acuity of pterygium patient was different from that of the control (P < 0.05). Besides, decreased intraretinal thickness of the IN and ON, increased intraretinal thickness of OT, decreased extraretinal thickness of OT, IN, ON, OS, and decreased retinal full layer thickness of medial superior, OS, IN, ON, and II subregions in pterygium group were observed. There was a negative correlation between RT of the IN and ON subregions and the length of pterygium (r = −0.5803 and r = −0.6013, P = 0.0376 and P = 0.0297). The RT of IN subregion was negatively correlated with pterygium area (r = −0.5844, P = 0.0359). According to the receiver operating characteristic analysis, in the ON subregion, the areas under the curve of the inner retinal thickness, outer retinal thickness and the whole retinal thickness were 1.0 (95% CI: 1.0), 0.882 (95% CI: 0.715 and 0.963), and 1.0 (95% CI: 1.0). The smallest area under the curve of retinal thickness in OT subregion was 0.018 (95% CI: 0–0.059).ConclusionRT of pterygium patients was significantly decreased, and the main alterations occurred in the temporal side suggesting there might exist retinal structural alterations in pterygium.

Application of a Deep Learning System in Pterygium Grading and Further Prediction of Recurrence with Slit Lamp Photographs.

Background: The aim of this study was to evaluate the efficacy of a deep learning system in pterygium grading and recurrence prediction. Methods: This was a single center, retrospective study. Slit-lamp photographs, from patients with or without pterygium, were collected to develop an algorithm. Demographic data, including age, gender, laterality, grading, and pterygium area, recurrence, and surgical methods were recorded. Complex ocular surface diseases and pseudopterygium were excluded. Performance of the algorithm was evaluated by sensitivity, specificity, F1 score, accuracy, and area under the receiver operating characteristic curve. Confusion matrices and heatmaps were created to help explain the results. Results: A total of 237 eyes were enrolled, of which 176 eyes had pterygium and 61 were non-pterygium eyes. The training set and testing set were comprised of 189 and 48 photographs, respectively. In pterygium grading, sensitivity, specificity, F1 score, and accuracy were 80% to 91.67%, 91.67% to 100%, 81.82% to 94.34%, and 86.67% to 91.67%, respectively. In the prediction model, our results showed sensitivity, specificity, positive predictive value, and negative predictive values were 66.67%, 81.82%, 33.33%, and 94.74%, respectively. Conclusions: Deep learning systems can be useful in pterygium grading based on slit lamp photographs. When clinical parameters involved in the prediction of pterygium recurrence were included, the algorithm showed higher specificity and negative predictive value in prediction.

A study on corneal astigmatism before and after pterygium excision

The prevalence of pterygium shows a substantial increase for increasing age and UV irradiation. There is paucity of available literature regarding the total area of pterygium, percentage of extension of pterygium on to the cornea and its effects on corneal astigmatism. Hence this study was undertaken to evaluate the pre and post-surgical effect of the size of the pterygium on corneal astigmatism. 100 out patients aged between 22 to 50 years diagnosed with pterygium were included in the study. Slit lamp bio microscope was used to measure the length and width of pterygium in millimetres. Slit beam was used to measure the diameter of cornea. Corneal astigmatism was measured pre and postoperatively on day 1 and 1 month follow up using keratometery. In this study 2.13±1.39 was the mean preoperative astigmatism, 1.36±1.03 was the mean post-operative astigmatism on day 1 and on 1 month follow up 0.86±0.91 was the mean post-operative astigmatism which was statistically significant(p&amp;#60;0.001)). The corneal astigmatism was directly proportional to pterygium area. As the area of pterygium increased the post-operative astigmatism significantly decreased. There was increase in corneal astigmatism with the increase in the percentage of pterygium extension onto cornea. In post-operative period the corneal astigmatism decreased with the increase in the percentage of pterygium extension onto cornea (p&amp;#60;0.001). As per our findings we draw a conclusion that surgical removal of pterygium significantly reduces pterygium induced astigmatism and also there is an improvement in visual acuity.

Does pterygium morphology affect corneal astigmatism?

Purpose:The purpose of this study was to evaluate the correlation between corneal astigmatism and the morphology of pterygium with anterior segment optic coherence tomography (AS-OCT).Material and Methods:The size of pterygium (horizontal length, vertical width) was measured manually; pterygium area and percentage extension of the pterygium onto the cornea were calculated. Anterior and posterior corneal astigmatism, Sim K, K1, K2 were measured using a dual Scheimpflug analyzer. Morphological patterns of the pterygium analyzed with AS-OCT were determined according to the extension of the pterygium apex below the corneal epithelium. Two tomographic patterns were identified: continuous and nodular. Correlation between anterior corneal astigmatism and pterygium size, percentage extension of the pterygium, and morphological pattern of the pterygium was analyzed.Results:The mean ages of the 47 patients were 49.4 ± 16.6 (22–80) years. Mean horizontal pterygium length, vertical width, pterygium area, and percentage extension of the pterygium were 2.8 ± 1.2 mm, 4.8 ± 1.6 mm, 7.42 ± 5.6 mm2 and 24.5 ± 10.4%, respectively. Mean anterior corneal astigmatism was 2.3 ± 2.3 D and simulated keratometry was 43.4 ± 2.02 D. In terms of the morphological pattern of the pterygium, 24 eyes had continuous, 23 eyes had a nodular pattern and the median (interquartile range) anterior corneal astigmatism was 1.87 (1.01–3.80) and 1.22 D (0.58–2.35), respectively (p = 0.102). Other topographic and pterygium size parameters were similar between groups. Analyzing the correlations in groups separately, a positive moderate statistically significant correlation was present between vertical width, percentage extension, pterygium area, and anterior corneal astigmatism in both continuous and nodular groups.Conclusions:Although not statistically significant, anterior corneal astigmatism was higher in continuous group. Using AS-OCT to standardize the morphology of pterygium could provide additional clinical information.

Ocular surface change of primary pterygium with OCULUS keratograph

Objective To study the correlation between pterygium area and the clinical manifestation and signs of primary pterygium obtained from OCULUS Keratograph. Methods A prospective case observation study was performed.Thirty-nine (55 eyes) primary pterygium patients were selected from June to September 2016 in Zhongshan People's Hospital.The area of the pterygium invaded cornea and duration of pterygium were recorded.The ocular surface condition was detected by corneal fluorescein staining.The break up time of tear film (BUT) and the gland function score were measured with OCULUS Keratograph.This study was approved by the Ethics Committee of Zhongshan People's Hospital(2015[13]). All operations followed the Helsinki Declaration and all patients signed informed consent forms. Results The areas of pterygium invaded cornea was 2-20 mm2, the mean size was 5(3, 10)mm2; the duration of pterygium was 3-8 years, the mean duration was 5(4, 6)years; the BUT was 2.1-15.0 seconds, the mean BUT was (6.3±3.0) seconds.The mean gland function score was 2(1, 3). The area of pterygium was not significantly correlated with the duration of pteryguim (r=0.197, P=0.148), while it was negatively correlated with BUT (r=-0.711, P<0.001 ) and positively correlated with the tarsal gland score (r=0.554, P<0.001). What's more, 82% (45/55 eyes) of the patients' tear film rupture appeared firstly near pterygium's head. Conclusion OCULUS Keratograph can directly evaluate the ocular surface condition of pterygium patients in a non-contact and non-invasive method.Assessing the ocular surface damage by observing the area of pterygium invaded cornea may provide a prospective treatment for pterygium patients. Key words: Pterygium; OCULUS Keratograph; Break up time of tear film

Comparison of self‐made cryopreservative fibrin glue and commercial fibrin glue kit in pterygium surgery: 1‐year follow‐up

To assess long-term efficacy and safety of self-made cryopreservative fibrin glue (SMC) applied in pterygium surgery. Prospective, comparative, interventional case series. Forty eyes of 40 patients with nasal primary pterygium, 24 male and 16 female, were enrolled. The patients were assigned to two groups and each contained 12 male and eight female based on the pterygium area encroaching onto the cornea. In one group, the conjunctival autograft was attached to the sclera with SMC stored for 2months, and in the other group, commercial fibrin glue kit (CK) was applied after the pterygium was removed. All the patients were followed up postoperatively on days 1, 3, 7 and 14 then at months 1, 3, 6, 12. The main outcome measures included operating time, postoperative discomfort, recurrence rate and complications. There were no significant differences in surgery time (p=0.713) and postoperative discomfort (day 1, 3, 7; p=0.747, p=0.766, p=0.983, respectively) between the two groups. By the end of 1-year follow-up, the recurrence rate was 0% in the SMC group and 5% in the CK group (p=1.000). There were no infections and severe visual acuity (VA) threatening complications in either group. Self-made cryopreservative fibrin glue (SMC) is as effective as standard CK for autograft fixation in pterygium surgery and it also has good safety after long-term follow-up. For its convenience and low cost, this new methods should be popularized, especially in underdeveloped area.

The Effect of Pterygium and Pterygium Surgery on Corneal Biomechanics

ABSTRACTPurpose: To evaluate the effect of pterygium and pterygium surgery on corneal biomechanics by ocular response analyzer (ORA, Reichert, USA). Methods: This study considered 68 eyes (from 34 patients with a mean age of 21.2±7.1 years) with unilateral nasal, primary pterygium (horizontal length <4 mm), and having undergone pterygium excision and conjunctival autografting. Pterygium length and area were measured from a photograph of the anterior segment using Image J program. ORA measurements were obtained before surgery and after the first month of the surgery. The measurements of the eyes with pterygium and healthy eyes were compared to evaluate the effect of pterygium. Similarly, measurements obtained before and after surgery were compared to evaluate the effect of pterygium surgery on corneal biomechanics. The correlation of the ORA measurements with the pterygium area was evaluated. Results: Mean pterygium horizontal length and area were 3.31±1.43 mm and 6.82±2.17 mm2, respectively. There was no statistically significant difference between the eyes with and without pterygium in corneal hysteresis (CH, p=0.442), corneal resistance factor (CRF, p=0.554), corneal-compensated intraocular pressure (IOPcc, p=0.906), and Goldmann-correlated IOP (IOPg, p=0.836). All preoperative parameters decreased after surgery; however, none of them were statistically significant (CH, p=0.688; CRF, p=0.197; IOPcc, p=0.503; IOPg, p=0.231). There were no correlations between pterygium area and ORA measurements (p>0.05). Conclusion: Pterygium <4 mm and its surgical excision did not affect corneal biomechanics. These results may be taken into account when cornea biomechanics, mainly intraocular pressure measurements, are important.

Chemokine CXCR-4 and cyclooxygenase-2 in the pathogenesis of pterygium

Background/aim: This study aimed to investigate the expression of chemokine receptor 4 (CXCR-4) and cyclooxygenase-2 (COX-2) in the epithelium and stroma of pterygium tissue in comparison with healthy conjunctiva. Materials and methods: The expression of CXCR4 and COX-2 was investigated by immunohistochemistry in the epithelium and stroma of the pterygium tissue of 29 eyes and compared with healthy conjunctival tissues. The correlation between CXCR4 and COX-2 expression as well as the correlation of these markers with the area of pterygium were evaluated statistically. Results: COX-2 staining scores were 1.75 ± 0.63 in the epithelium and 1.20 ± 0.62 in the stroma of the pterygium tissue. Mean CXCR-4 staining in the epithelium was 0.069 ± 0.37, whereas it was 5.0 ± 2.84 cells in the stroma. There was almost no staining of COX-2 and CXCR4 in the control samples. There was a strong positive correlation between the expression of CXCR-4 and COX-2 in the stroma of the pterygium. Conclusion: CXCR-4 and COX-2 may play important roles in the pathogenesis of pterygium.

Risk Factors for Recurrence After Pterygium Surgery: An Image Analysis Study.

To determine the risk factors related to recurrence of pterygium using automated image analysis. This study included 149 eyes of 149 patients who underwent pterygium excision and limbal-conjunctival autograft. Demographic variables including age and sex were collected. Image analysis was performed using anterior segment photographs taken preoperatively to measure relative length (horizontal length of pterygium invading cornea/horizontal corneal diameter), relative width (width of pterygium invading cornea/vertical corneal diameter), relative area (RA; area of pterygium invading cornea/total corneal area), and vascularity index (VI; degree of vascularity). In all patients, recurrence of pterygium was determined at 1 year after surgery. Association between these factors and recurrence rate was evaluated with univariate and multivariate analyses. Recurrence at 1 year was reported in 18.8% (28/149) of the patients. Univariate analysis showed that relative length (P = 0.001), relative width (P = 0.031), relative area (P = 0.009), and VI (P < 0.001) were significantly associated with increased risk of recurrence, whereas age and sex had no significant association with recurrence. In multivariate analysis, only VI (P < 0.001) had significant correlation with recurrence. Patients with VI ≥30 had significantly higher recurrence rate than those with VI <30 (33.3% vs. 8.1%, P < 0.001). Increased vascularity was associated with a higher risk of recurrence. Quantification of vascularity using automated image analysis might be useful in predicting the risk of recurrence.

Quantification of Astigmatism Induced by Pterygium Using Automated Image Analysis

To determine the factors influencing pterygium-induced astigmatism (PIA) and to develop a prediction model of PIA using these factors. This cross-sectional study included 97 eyes of 97 patients who underwent a pterygium excision and a limbal conjunctival autograft. Anterior segment photographs were taken preoperatively, and corneal topography was done preoperatively and at 3 months postoperatively. PIA was defined as the vector difference between the topographic astigmatism preoperatively and at 3 months postoperatively. Image analysis was performed using anterior segment photographs to measure the relative length (RL) (horizontal length of pterygium invading the cornea/horizontal corneal diameter), relative width (width of pterygium invading the cornea/vertical corneal diameter), relative area (area of pterygium invading the cornea/total corneal area), and vascularity index (VI) (degree of vascularity). Association between these factors and PIA was evaluated with univariate and multivariate analyses. We also attempted to generate a model for prediction of PIA using these factors. Univariate analysis showed that the RL, relative width, relative area, and VI were significantly associated with PIA (P < 0.001 for all variables, Pearson coefficient (r) = 0.708, 0.555, 0.606, and 0.642, respectively). In multivariate analysis, only the RL (P < 0.001) and VI (P < 0.001) had significant correlation with PIA. A multiple regression model for PIA was generated as follows: PIA = 0.080 × RL (%) + 0.039 × VI - 0.823 (r = 0.502, F = 95.71, P < 0.001). Larger lengths and increased vascularity were associated with larger PIA. PIA can be predicted by evaluating the length and vascularity of pterygium involving the cornea.

The Influence of Chemokine CXCR4 and Cyclooxygenase-2 in the Recurrence of Pterygium

ABSTRACTPurpose: To investigate the role of CXCR4 and cyclooxygenase-2 in pterygium recurrence.Methods: A total of 18 primary and 9 recurrent pterygium samples were analyzed. Immunohistochemical staining using primary antibodies against cyclooxygenase-2 and CXCR4 was performed. The cyclooxygenase-2 and CXCR4 expressing cells were calculated separately on the epithelium and stroma. In addition, a correlation between the area of pterygium and CXCR4 and cyclooxygenase-2 levels was investigated.Results: In the primary pterygium group, cyclooxygenase-2 staining was more intense in the epithelium and more dominant in the stroma of the recurrence samples. The CXCR4 expression was more intense in the stroma of both groups. The highest CXCR4 expression was observed in the recurrent pterygium group. There was a strong correlation between the area of pterygium and CXCR4 and cyclooxygenase-2 of stroma.Conclusions: CXCR4 and cyclooxygenase-2 may play an important role in the recurrence of pterygium.

Conjunctival Lymphangiogenesis Was Associated with the Degree of Aggression in Substantial Recurrent Pterygia.

Objective. To examine conjunctival lymphatic vessels and to analyze the relationship between lymphangiogenesis and aggressive recurrent pterygia. Methods. Tissues from 60 excised recurrent (including 19 of Grade 1, 28 of Grade 2, and 13 of Grade 3) pterygia were used in the study. Tissues from 9 nasal epibulbar conjunctivae segments were used as controls. Pterygium slices from each patient were immunostained with LYVE-1 monoclonal antibodies to identify lymphatic microvessels in order to calculate the lymphovascular area (LVA), the lymphatic microvessel density (LMD), and the lymphovascular luminal diameter (LVL). The relationship between lymphangiogenesis (LVA, LMD, and LVL) and pterygium aggression (width, extension, and area) was clarified. Results. Few LYVE-1 positive lymphatic vessels were found in the normal epibulbar conjunctiva segments. Lymphatic vessels were slightly increased in Grades 1 and 2 and were dramatically increased in Grade 3 recurrent pterygia. The LMD was correlated with the pterygium area in Grade 1 and 2 pterygia. In Grade 3, both LVA and LMD were significantly correlated with the pterygium area. Conclusions. Lymphangiogenesis was associated with the degree of aggression in recurrent pterygia, particularly in substantial Grade 3 recurrent pterygia.

Subconjunctival Bevacizumab Injection in Treatment of Recurrent Pterygium

Objective: To determine the clinical effect of subconjunctival injection of bevacizumab in regression or halting growth in patients with recurrent pterygium.Method and materials: The study was an off-label; 2-dosing, interventional case series involving 20 patients with recurrent pterygium. They received subconjunctival bevacizumab (0.2 ml/2.5 mg). Vascularity and thickness of Pterygium was graded. Size of the pterygium (measured by surface area in cm2) was recorded from baseline to 6 months, after injection. Treatment-related complications and adverse events were reported. The main outcome of measurements was the change in grading, size, vascularity, thickness and color intensity.Results: 9 males (45%) , 11 females (55%) of 20 patients were conducted in study with a mean age of 50.46 years ± 18.30 (rang 38-70). There was a significant reduction in grading with significant difference in the mean surface area of pterygium at different intervals (P<0.05) and the size of pterygium was reduced. The reduction of color intensity was significant (P=0.031). No significant topical or systemic adverse reactions were recorded.Conclusions: Subconjunctival bevacizumab injection is useful in management of patients with recurrent pterygium without significant local or systemic adverse effects.

A Randomized Controlled Trial of Intralesional Bevacizumab Injection on Primary Pterygium: Preliminary Results

To evaluate the efficacy and safety of intralesional injection of bevacizumab on primary pterygium treatment. In this randomized controlled trial, each primary pterygium patient was randomized to receive either an intralesional injection of bevacizumab 2 mg (1 mg/0.04 mL) or a combination of topical antihistamine (antazoline HCl 0.05%) and vasoconstrictor (tetrahydrozoline HCl 0.04%) as a control. The main outcome measurements were symptoms and signs (including eye irritation, epiphora, redness, amount of discharge, inflammation and elevation of pterygium, and percentage of corneal pterygium area). A total of 74 pterygium eyes in 66 patients were randomized and allocated into a treatment group (N = 34) and a control group (N = 40). In the treatment group, there was a statistically significant reduction of symptoms (including irritation, photophobia, epiphora, redness, discharge, and blurred vision) and signs (inflammation and corneal pterygium area) compared with the baseline, up to at least 6 months. Between the treatment and control groups, no significant differences were found for all visits with respect to the (1) symptoms, (2) signs, and (3) percentage of corneal pterygium. Intralesional bevacizumab may have a therapeutic effect on symptoms and signs of primary pterygium for at least 6 months (ie, the follow-up period), with no serious ocular or systemic adverse effects.

Comparison of Fibrin Sealant and Sutures for Conjunctival Autograft Fixation in Pterygium Surgery: One-Year Follow-Up

Aims: To evaluate the efficacy and safety of fibrin sealant in conjunctival autograft fixation in pterygium surgery. Methods: Prospective, comparative, interventional case series. 40 eyes of 40 patients with nasal primary pterygium, 24 male and 16 female, were enrolled. The patients were assigned to two groups and each contained 12 male and 8 female based on the pterygium area encroaching onto the cornea. In one group the conjunctival autograft was attached to the sclera with fibrin sealant and the other group with nylon 10–0 sutures. All the patients were followed up postoperatively on days 1, 3, 7 and 14 then at months 1, 2, 6 and 12. The main outcome measures included operating time, postoperative symptoms, graft success, recurrence rate and complications. Results: The average operating time was significantly shorter (p < 0.001) in the fibrin sealant group and fewer postoperative symptom complaints were received as well. By the end of 1-year follow-up, the recurrence rate was 5% in the fibrin sealant group and 10% in the suture group (p = 1.000), and there was no statistically significant difference in complications (p > 0.05) between the two groups. Conclusions: It is safe and effective to use fibrin sealant for conjunctival autograft fixation. This method causes much fewer postoperative symptoms and shortens surgery time significantly, and the long-term results are also favorable.