Conjunctival Autograft Research Articles

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

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.

Suture Less and Glue-Free Inferior Limbal Conjunctival Autograft Transplantation in Primary Pterygium Surgery: A Case Series

Introduction: Conjunctival autografting which is the mainstay in the management of pterygium. The conjunctival graft is most commonly harvested superiorly. However, superior bulbar conjunctiva may not be available for harvesting a graft in all cases and it would affect the outcome. This study aims at the efficacy of the inferior bulbar conjunctival grafting without using any suture or glue. 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 100 eyes of 98 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 100 cases were included in this case series. Patient’s age ranged from 18 to 83 years (mean 48.08±12.76 years). Total graft dehiscence occurred in 2 eyes (2%), graft retraction in 10 eyes (10%), and recurrence was seen in 1 eye (1%). At 3 months postoperatively, the gain in uncorrected visual acuity ranged from 2-3 lines in the Snellen chart in 9 eyes, symblepharon does not occur in any patient and no other complication was noted. Conclusion: Our study shows that this simple technique for pterygium surgery may prevent the potential risk of bad outcomes of future filtration surgery and overcome the conditions when superior bulbar conjunctiva may not be available for harvesting a graft.

Technique of Excision of Double Head Pterygium with Conjunctival Autograft from both Eyes

Background: Pterygium is not just a degenerative disease, but may be a proliferative disorder of the ocular surface. Objective: The aim of this study was to describe a technique of conjunctival autograft from both eyes for primary double head pterygium and evaluate its post operative result. Methodology: This retrospective study was conducted in the department of Ophthalmology at Monno Medical College, Manikganj, Bangladesh from July 2022 to December 2022 for duration of six months. After fulfill the selection criteria underwent conjunctival autograft from both eyes. Primary outcome measure was recurrence rate, graft retraction, Tenon's granuloma, dellen formation. Results: The highest patients belong to 35 to 45 years age group is about 18(60.0%) in this study. The number of male patients was 10 and that of female patient 20. There was no recurrence in this study. However, there were postoperative oedema (6.66%), sub-conjunctival haemorrhage (63.33%), graft retraction (20.0%), dellen (0.0%), Tenon’s granuloma (10.0%). Conclusion: In conclusion conjunctival autograft from both eyes appears to be successful technique with 0 recurrence rate in treating double head pterygium. Journal of Monno Medical College June, 2024;10 (1):03-06

Comparison of bare sclera combined with mitomycin c technique and limbal- conjunctival autograft technique in primary pterygium surgery

Comparison of bare sclera combined with mitomycin c technique and limbal- conjunctival autograft technique in primary pterygium surgery

Pterygium Excision with Conjunctival Autograft: Sutures Vs Sutureless Technique

Pterygium Excision with Conjunctival Autograft: Sutures Vs Sutureless Technique

Intraocular Lens Power and Corneal Topographic Change After Pterygium Surgery

PurposeTo investigate the impact of pterygium excision on intraocular lens (IOL) power calculation and corneal astigmatism. DesignsProspective cohort study MethodsWe enrolled 30 eyes with primary pterygium that underwent pterygium excision with a conjunctival autograft. IOL power calculation and keratometry using the IOL Master 700, along with topographic parameters using the Pentacam Scheimpflug topography system, were performed preoperatively and at 1, 3, 6, and 12 months postoperatively. We analyzed correlations between pterygium length/area and IOL power, as well as corneal topographic changes. ResultsThe mean pterygium length was 2.08 ± 0.58 mm, and the mean area was 6.05 ± 2.41 mm2. One year after pterygium surgery, the calculated IOL power values using all formulas were lower than the preoperative values. Pterygia with a horizontal length of 1.73 mm and an area of 4.45 mm2, and those with a horizontal length of 2.25 mm and an area of 6.95 mm2 created 0.5 D and 1.0 D errors in calculated IOL power, respectively (p<0.001). The calculated IOL power values changed significantly from preoperative to six months postoperatively but did not change significantly from six to 12 months postoperatively. Pterygia with a horizontal length greater than 1.83 mm (p<0.001) and an area greater than 5.1 mm2 (p < 0.001) created a 2.0 D error in anterior corneal astigmatism. ConclusionsPterygium causes errors in IOL power calculation, with greater pterygium length/area exerting a larger effect. Cataract surgery with IOL implantation is recommended at least six months after pterygium surgery. In combined case, calculated IOL power should be decreased by 0.5-1.5 D based on the pterygium length/area.

Comparison of the effects of 0.05% topical cyclosporine A versus 0.1% topical cyclosporine A on recurrence and clinical parameters following pterygium surgery.

To compare the efficacy of topical 0.05% cyclosporine A (CsA) and 0.1% topical cyclosporine A (CsA) over a 6-month period following pterygium surgery, specifically evaluating their effects on postoperative recurrence and clinical parameters. This clinical study enrolled 245 patients with pterygium who underwent surgery using the conjunctival autograft technique with mitomycin C (MMC) were enrolled. Participants were divided into three groups: Group 1 (0.05% CsA) (n = 80), Group 2 (0.1% CsA) (n = 80), and a control group (n = 85). They were examined at postoperative first day, first week, first month and sixth month. The examination included best corrected visual acuity (BCVA), intraocular pressure (IOP), presence of inflammation, and ptergium recurrence, all of which were compared across the groups. The mean age of the patients was 63.22 ± 9.39 years, with 53.3% male and 46.7% female. The three groups were similar in terms of demographic characteristics and pterygium size. Inflammation in surgical area significantly regressed in all groups at 6 months postoperatively (p < 0.05). Inflammation in the first and sixth months was not different between the groups (p = 0.118, p = 0.580, and p = 0.435, respectively). The recurrence rate was not different between groups (p = 0.890). There was no statistically significant difference between groups regarding IOP (p = 0.818). A significant increase in BCVA after surgery was observed in three groups compared to preoperative levels (p < 0.05). This study showed that there was no difference between the efficacy of 6 month topical 0.05% CsA and 0.1% CsA application after pterygium surgery with the conjunctival autograft technique with MMC on postoperative outcomes. Including postoperative recurrence, IOP changes, BCVA changes and surgical area inflammation.

Prospective Study: Utility of Anterior Segment Optical Coherence Tomography to Identify Predictive Factors of Recurrence in Pterygium Surgery.

Background/Objectives: The main purpose of this study is to determine, by anterior segment optical coherence tomography (AS-OCT), the anatomical characteristics, both preoperatively and postoperatively, that correlate with a higher rate of pterygium recurrence after surgery with exeresis and conjunctival autograft with biological glue. Methods: A total of 50 eyes which were listed for primary pterygium surgery at an ophthalmology tertiary centre were treated with standard pterygium excision and a conjunctival autograft with tissue glue. Ten variables were measured with AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan) during six control visits with all patients. Finally, statistical analysis was performed using SPSS (SPSS stadistics®, IBM®, version 21.0.0.0) for descriptive variables and R-project (The R foundation©, version 3.0.2) for the rest of the analyses, including a descriptive analysis and an inferential analysis studying prognostic factors of recurrence and their predictive capacity. Results: Among the 50 patients who underwent surgery, recurrence was detected in 8 cases (rate 16%; 95% CI: 5.8-26.2%). Most cases (n = 6) were detected 3 months after surgery. The pattern of recurrences was atrophic in two thirds of the cases; none required reintervention. Preoperative total conjunctival thickness at 3 mm was significantly increased in patients who developed recurrence. One week after surgery, epithelial and stromal thickness at 1 mm and total thickness at 3 mm proved to be useful for predicting recurrence. Both models have significant discriminant capacity. Conclusions: By imaging the graft with AS-OCT preoperatively and 7 days after surgery, the risk of future recurrence can be predicted.

Assessment of conjunctival autograft reperfusion after pterygium surgery by optical coherence tomography angiography (OCT-A)

PurposeTo investigate the healing process of conjunctival autografts (CAG) following pterygium surgery using optical coherence tomography angiography (OCTA). MethodsTwenty-one eyes of 21 patients diagnosed with pterygium underwent pterygium excision with CAG without using Mitomycin-C. Over a 12-week follow-up period, changes in vascular density (VD), vascular density index (VDI), and vascular length density (VLD) were assessed at two distinct depths: superficial (<200 μm) and deep (>200 μm) using OCTA. Additionally, the revascularization rate and pattern were evaluated. ResultsDuring the first week, the CAG was edematous and no sign of neovascularization was observed. In 4th week edema decreased and early signs of vascular formation appeared. In the 12th week, the deep vasculature demonstrated a greater density of interconnectivity compared to the superficial layers. VD and VLD significantly increased during the follow-up period (P < 0.05). The CAG blood flow signals exhibited a chaotic pattern, deviating from the expected centrifugal vascular pattern in the surrounding normal conjunctiva. ConclusionOCTA imaging emerges as a reliable tool for the assessment of CAG vascularization, improving the monitoring of the healing process in the postoperative period. The evaluation of CAG revascularization patterns appears to be promising biomarkers that can predict the potential future recurrence.

The Role of 20% Ethanol in Enhancing Pterygium Surgery Outcomes: A Clinical Study.

Introduction Pterygium is an ocular surface disorder characterized by a hyperplastic growth of conjunctiva encroaching over the cornea. It causes redness, watering, and foreign body sensation. Surgical excision is the preferred mode of treatment when there is encroachment over the visual axis, chronic irritation, restricted ocular motility, and cosmetic concerns. Various surgical methods have been adopted for the treatment and to prevent recurrences. This study assessed the effectiveness and safety of 20% ethanol as an adjuvant in pterygium excision with conjunctival autograft implantation, evaluating surgical outcomes. Methods A prospective hospital-based interventional study was conducted among 30 patients with pterygium from August 2022 to December 2023. Patients were evaluated preoperatively for anterior segment, posterior segment, visual acuity, and corneal astigmatism. Pterygium was excised using 20% ethanol as an adjuvant, and conjunctival autograft was placed over the bare sclera without sutures. Patients were evaluated on postoperative days 1, 8, 30, and 90 for graft condition, visual acuity, corneal astigmatism, and associated complications. Results After three months of follow-up, the mean visual acuity improved to LogMAR 0.46±0.35 (p=0.001), which was statistically significant, and the average corneal astigmatism decreased from 3.36±2.87 to 0.87±0.57 (p=0.0001). No recurrence was noted among the participants. Conclusion This study has shown that using 20% ethanol as an adjuvant for pterygium excision facilitated clean dissection of a pterygium from the underlying cornea and the pterygium-induced corneal astigmatism has significantly decreased, which led to progress in vision.

Surgically Reduced Cornea Astigmatism Post-Pterygium Excision Followed by Conjunctival Autograft at Preah Ang Duong Hospital: Prospective Study

Surgically Reduced Cornea Astigmatism Post-Pterygium Excision Followed by Conjunctival Autograft at Preah Ang Duong Hospital: Prospective Study

Comparative Evaluation of Surgical Techniques for Pterygium Management: An In Vitro Study

ABSTRACT Background: Pterygium is a common ocular surface disorder characterized by the growth of fibrovascular tissue onto the cornea, leading to discomfort and visual impairment. Various surgical techniques, including conjunctival autografting, amniotic membrane transplantation, and bare sclera excision, are employed in the management of pterygium. Materials and Methods: Cultured human conjunctival epithelial cells were subjected to simulated pterygium conditions, mimicking the fibrovascular proliferation observed in vivo. Subsequently, different surgical techniques, including conjunctival autografting, amniotic membrane transplantation, and bare sclera excision, were simulated in vitro. Cell viability, proliferation, migration, and inflammatory cytokine expression were assessed using various assays, including MTT assay, scratch assay, and enzyme-linked immunosorbent assay (ELISA). Untreated cells served as controls for comparison. Results: Conjunctival autografting demonstrated superior outcomes in terms of cell viability and proliferation compared to amniotic membrane transplantation and bare sclera excision. Autografted cells exhibited a significantly higher percentage of viable cells and enhanced proliferative capacity compared to cells subjected to other surgical techniques (P &lt; 0.05). Additionally, conjunctival autografting promoted faster cell migration into the defect area, resulting in more rapid wound closure compared to other techniques. Furthermore, reduced expression of inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), was observed in cells treated with conjunctival autografts compared to other groups. Conclusion: In vitro findings suggest that conjunctival autografting may offer superior outcomes in the management of pterygium compared to amniotic membrane transplantation and bare sclera excision.

Comparison of TGF-β and Type 1 Collagen Expression between Platelet Rich Fibrin Membrane and Conjunctival Autograft Treatment after Conjunctival Excision (An Experimental Animal Model Study)

Purpose: To compare TGF- β and type 1 collagen expression between Platelet rich fibrin (PRF) membrane and conjunctival autograft treatment after conjunctival excision. Study Design: Experimental animal study. Place and Duration of study: Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia from October 24, 2022 to November, 19, 2022 Methods: Twenty New Zealand white rabbits were randomly assigned to either the PRF group or the conjunctival autograft group. A 5x5 mm excision was made in the temporal quadrant of the right eye of each rabbit. In the first group, the conjunctival defect was closed using a PRF membrane, while in the second group, closure was done with a conjunctival autograft from the superior quadrant of the same eye. After 14 days, all rabbits were terminated and enucleated. An immunohistochemical study of conjunctival tissue was conducted to assess TGF-β and type 1 collagen expression, and results were statistically analyzed. Results: An independent T-Test revealed that PRF membrane group exhibited higher TGF-β expression compared to the conjunctival autograft group (p = 0.000), with a mean TGF-β expression of 9.02 in the PRF membrane group and 5.76 in the conjunctival autograft group. Conversely, type 1 collagen expression was found to be higher in the conjunctival autograft group compared to the PRF membrane group (p = 0.032), with a mean type 1 collagen expression of 9.22 in the conjunctival autograft group and 6.92 in the PRF membrane group. Conclusion: TGF-β expression was higher in the PRF group and type 1 collagen expression was higher in the conjunctival autograft group.

Contralateral anaesthesia following peribulbar block- Unveiling a rare ocular complication

Peribulbar anesthesia is a common regional block in intraocular surgeries with an excellent safety profile. We report a rare case of contralateral loss of accommodation and extraocular muscle palsy following peribulbar block (PBB). A patient with right-eye pterygium was planned for pterygium excision with conjunctival autograft under PBB. After PBB, the patient developed blurring of vision and loss of extraocular muscle movements in the contralateral eye. Contrast-enhanced computed tomography scan of the brain and orbit was unremarkable. The patient was stabilized, and surgery was deferred. The patient’s vision and extraocular movements returned spontaneously after 4–5 hours.

Comparative study of pterygium excision with suture and sutureless conjunctival autograft

Introduction and aim. This is a prospective interventional study to compare corneal astigmatism before and after pterygium excision with conjunctival autograft, to determine the difference in mean corneal curvatures before and after pterygium excision, to evaluate the safety and efficacy of autologous blood technique, and sutured conjunctival autograft for primary pterygium. Material and methods. Patients were divided into group A – pterygium excision+sutured conjunctival limbal autograft and group B – pterygium excision+autologous conjunctival limbal autograft under local anesthesia. The preoperative and post operative K1 and K2 values and BCVA were noted. Results. There was statistically significant reduction in mean astigmatism at each post operative follow up in group A at 1 week (p=0.0249), 2 weeks (p=0.004), 1 month (p=0.0031) and at 3 months (p=0.0009) and similarly in group B post operative follow up at 1 week (p=0.0011), 2 weeks (p=0.0021), 1 month (p=0.0009) and at 3 months (p=0.0003). Conclusion. Pterygium surgery decreases the cylindrical error and reverts corneal curvatures to normal, thus improving subjective visual acuity. Astigmatism produced by the pterygium is reduced after surgery We found autologous conjunctival autograft is superior than sutural conjunctival autograft. Pterygium causes astigmatism depending upon the size of pterygium it should be surgically removed to prevent obstruction in the vision.

Primary Pterygium Excision Surgery: Analysis of Risk Factors and Clinical Outcomes.

Purpose To evaluate clinical outcomes of primary pterygium excision surgery and analyze risk factors for pterygium recurrence. Setting Eye Treatment Centre, Cornea and External Diseases Service, Whipps Cross Hospital, London, United Kingdom. Methods Retrospective case series of eyes undergoing primary pterygium excision between August 2017 and July 2022. Patients who underwent "pterygium excision" documented in the electronic patient record system were identified. Patients with recurrent pterygium and those lost-to-follow-up were excluded. The duration of follow-up, type of surgery performed (primary conjunctival closure, conjunctival autograft, and amniotic membrane transplantation), recurrences with respect to the type of surgery performed, and postoperative complications were collected and analyzed. Results In total, 83 eyes (from 79 patients) were included. The mean age of our patient cohort was 59.3 ± 5.9 years. The most common ethnic distribution was Black Caribbean (15.7%). Conjunctival autograft was performed in 76 eyes (91.6%), primary conjunctival closure was performed in five eyes (6%) and amniotic membrane transplantation was performed in two eyes (2.4%). The recurrence rate with conjunctival autograft was 1.3% with a median time to recurrence of 2.98 months. Recurrence was significantly more common in patients below the age of 40 years (p=0.03). Recurrence was not significantly associated with gender (p=0.23), ethnicity (p=0.17), or grade of surgeon (p=0.38). Conclusion Our findings demonstrate the effectiveness of conjunctival autograft with fibrin glue fixation for the surgical management of primary pterygium. Recurrence was found to be significantly more common in patients under the age of 40 years old. However, recurrence was not associated with ethnicity,gender, or surgeon grade.

A Study of Reccurence of Pterygium in Maharashtra

Background This study investigated the recurrence rates of primary pterygium following different surgical approaches, including conjunctival autografting alone, conjunctival autografting with intraoperative mitomycin C, and amniotic membrane grafting.  Methods In a retrospective cohort study of primary pterygium conducted from October 2022 to October 2024, 560 patients with an average age of 53.3 ± 14.1 years were included, with 94 cases undergoing surgery. Pterygium involving the cornea was present in 55% of cases. The overall recurrence rate for the three procedures was 17%, with an average time to recurrence of 14.2 ± 11.9 months, and 37% of recurrences occurred after the first year. Dry eye disease was the only significant risk factor for recurrence in both univariate (p = 0.021) and multivariate analysis (p = 0.026). The recurrence rates following conjunctival autografting with and without mitomycin C were 15.6% and 15.8%, respectively, while the rate following amniotic membrane grafting was twofold higher at 27% (OR= 2.02) compared to conjunctival autografting (15.8%).  Conclusions Dry eye disease was identified as the sole factor associated with pterygium recurrence in this study. The finding highlights the significance of extended post- operative monitoring, as over one-third of recurrences were detected after the first year. The slightly elevated recurrence rate following conjunctival grafting in our study, compared to existing literature, can be attributed to variances in study locations, demographics, and follow- up durations.

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery: a technique note.

To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation. Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability. Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min vs 18.15±2.20min, P=0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) vs 3.00min (2.21-4.15), P<0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (P<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) vs 2 (1-4), P<0.001]. Postoperative symptoms at 6mo were comparable between the groups (P=0.487), with no recurrence. ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.

Comparison of the recovery characteristics for canine corneal ulcer treated with corneoconjunctival transposition or conjunctival autografts

Corneal ulceration induced by Staphylococcus pseudintermedius (S. pseudintermedius) is a common clinical eye disease. Antibiotics combined with corneoconjunctival transposition (CCT) or conjunctival autografts (CA) are often used, but the recovery characteristics are still unknown. In this experiment, canine corneal ulcer models induced by S. pseudintermedius and treated with levofloxacin eye drops (LED) were created. The models were used to compare the recovery characteristics of CCT and CA, combined with LED, by clinical observation, histopathology, and cytokine expression detected by qRT-PCR analysis. The results showed that the ulcerative cornea with only LED treatment perforated after 48 h. The mRNA expression of TLR2, IL-1β, IL-6, IL-8, and TNF-α genes was significantly elevated on 14, 28, and 35 days after the surgery compared to normal (p < 0.01). On day 42, the inflammatory damage had resolved, but the corneal transparency and arrangement of collagen fibrils in the CCT group were higher than those in the CA group. The mRNA expression of EGF, FGF, TGF-β1 and VEGF genes increased significantly (p < 0.01), mostly until day 42, proving that CCT and CA surgery contributed to the corneal recovery, and relieved the inflammatory reaction, with the elimination of corneal cicatrices needing a period of reconstruction. Therefore, this study has provided, for the first time, the method for establishing a canine corneal ulcer model induced by S. pseudintermedius. More importantly, the recovery of canine ulcerative corneas with CCT or CA surgery is reported for the first time.

Comparison of recurrence rate of primary pterygium using conjunctival autograft with sutures versus suture-free approach.

Objective: To compare the recurrence rate of primary pterygium treated with conjunctival autograft (CAG) using sutures versus a suture-free approach. Methodology: From July 2022 to December 2022, a quasi-experimental study was carried out at the Institute of Ophthalmology, Liaquat University of Medical &amp; Health Sciences Jamshoro. A total of 110 patients with primary pterygium underwent treatment with conjunctival autograft using sutures or a suture-less/glue-free approach, under local anaesthesia. The patients were monitored for 12 months after surgery to assess recurrence and complications, and all procedures were performed by a single surgeon. Data was collected and analyzed on SPSS version 22. Result: The study included 110 patients with pterygium, mostly males (71.81%) and from rural areas, with the nasal location being the most common. Group A had 3 recurrences at 3 and 6 months, while Group B had 4 recurrences at similar intervals. Group A had fewer complications, including graft oedema, retraction, granuloma, and giant papillary conjunctivitis, while Group B had three cases of retraction. The recurrence rate was found to be 5.08% and 7.70% with and without sutures (P value ≥ 0.53) respectively. Conclusion: The excision of primary pterygium using conjunctival autograft with sutures or suture-free/glue-free methods are safe and uncomplicated procedure that results in lower levels of induced astigmatism, improved cosmetic appearance, no tissue loss, reduced recurrence of pterygium, and decreased risk of, scleral thinning, granuloma formation. Suture-free conjunctival autograft results in less postoperative manifestation like discomfort foreign body sensation, shorter surgery time, and high levels of patient satisfaction compared to conjunctival autograft with sutures. Key words: Primary pterygium, autograft and pterygium. recurrence rate of pterygium, suture with pterygium.