Free Conjunctival Autograft Research Articles

COMPARISON OF SUTURELESS, GLUE-LESS CONJUNCTIVAL AUTOGRAFT VERSUS SUTURED LIMBAL CONJUNCTIVAL AUTOGRAFT FOR PRIMARY PTERYGIUM

Objectives: The objective of the study was to compare and evaluate efficacy of two surgical techniques for the management of primary pterygium in terms of complications and post-operative signs and symptoms. Methods: The study included 60 patients with primary pterygium. The mean age was 42±10 years (range 22–62 years). Simple excision under local anesthesia was performed followed by closure of the bare sclera by suture less and glue free conjunctival autograft in 30 patients (Group I), versus the conventional method of a sutured conjunctival autograft in 30 patients (Group II). Results: At Visit 1, 6 patients (20%) of Group I had Graft edema in comparison to 5 patients (16.67%) in Group II. Subcutaneous hemorrhage was noted in 6 (20%) patients in both the groups. Graft retraction was noticed in 4 patients (13.33%) in Group I and in 2 patients (6.66%) in Group II. Graft dislodgement was observed in 1 patient (3.33%) in Group I. One (3.33%) case of recurrence was reported at 6 months in Group I whereas 2 (6.67%) cases were reported in Group II. One case of Granuloma was reported in Group II. There were significantly lower post-operative signs and symptoms in Group I as compared to Group II in the 1st post-operative week and the difference between the two groups was statistically significant (p<0.05) at visit 1 and visit 2. The satisfaction survey revealed higher overall satisfaction score for Group I as compared to Group II. Conclusion: Sutureless technique may be considered as a viable alternative to sutured technique in terms of surgical outcomes. It scores better in terms of post-operative symptoms when compared to sutures.

Sutureless and Glue Free Conjunctival Autograft in Pterygium Surgery

Objective: The objective of the study is to report a newer technique of pterygium excision followed by suture less and glue free conjunctival autograft for its complications and recurrence rate. 
 METHODS: This prospective and quassi experimental study was carried out at Baqai medical university hospital, Karachi from January 2016 to December 2016. This study consists of 30 eyes of 22 patients, above 15 years of age with primary progressive Pterygium of 2 mm or more in size and interfering with the vision. All the patients were operated under sub tenon’s anesthesia, Pterygium was excised with surgical blade followed by suture less and glue free conjunctival autograft from superior limbus. Primary outcomes measures included graft loss, granuloma and any other complications noted within six months. Recurrence was also noted at 6 months.
 RESULTS: There were 30 eyes of 22 patients. There were 4 females (18.18%) and 18 male patients (81.81%). The mean age was 31.28 years ± 9.4 SD. Right eye was seen in 16 (53%) cases. Graft lost was recorded in 1 patient (4.5%), conjunctival pyogenic granuloma in 1 patient (4.5%) and graft retraction was seen in 1 (4.5%) case. Recurrence rate was none at 6 months post operatively.
 CONCLUSION: Conjunctival autograft without suture and glue is a new and simple technique that can be done with minimal expenses and limited resources. It has fewer complications and no recurrence.

Recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient: a case report

BackgroundLigneous conjunctivitis is a rare form of chronic pseudomembranous conjunctivitis which usually starts during infancy. We report on an unsual case of recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient.MethodsThe equipment used for the slit-lamp images was a Haag Streit slit lamp BX900 Sn 00,406 with 16 × magnifications. The used batch number of the camera was sn00406 and the software was from the company CCS Pawlowski Merge Eye. There were no filters used. The images were saved with a resolution of 300 DPI. Neither downstream nor averaging was used to enhance the resolution of the image in the case presentation section or the figure legend.The equipment used for the cross-sectional histologic images was a Zeiss Axioskop 40 microscope with an objective lens Zeiss A-Plan × 20/0.45 (Zoom 6.3 × TV 2/3″″C). The used camera was AxioCam MRc5 and the software was ZEN 3.2. The cross-sectional histologic images were saved with a resolution of 2584 × 1936 Pixels. Neither downstream nor averaging was used to enhance the resolution of the image in the case presentation section or the figure legend.Case presentationThis is a rare case report of ligneous conjunctivitis in a 67-year-old male patient who presented a recurrent conjunctival granuloma after five excisions following cataract surgery in his left eye. We performed a tumor excision with free conjunctival autograft. The histology showed a fibrin crust including macrophages, granulocytes, lymphocytes, and reactively altered squamous cell nests. These findings were consistent with a ″pseudomembrane in conjunctivitis lignosa″. We administered a topical combination of plasminactivator, heparin, cortisone and cyclosporine.ConclusionThis treatment with the combination of plasminactivator, heparin, cortisone and cyclosporine has proven to be effective in preventing the recurrence of ligneous conjunctivitis.

Update on overview of pterygium and its surgical management.

Pterygium is a bulbar conjunctival fibrovascular growth that crosses the limbus and extends onto the peripheral cornea, and in some cases leads to significant visual complications. The prevalence of this disease has been reported to be from 1.2% to about 40% in different parts of the world. Although there are various risk factors for pterygium, which include ultraviolet (UV) radiation, viral infection, hereditary factors, immune factors, aseptic inflammation, and environmental irritation, the pathogenesis of pterygium is mainly related to exposure to UV light. In addition to cosmetic problems, pterygium can lead to eye irritation, disrupt the transparency of cornea on the pupil area, and cause disorders such as corneal astigmatism and damage to the visual axis leading to vision impairment. In the last few years, the treatment of pterygium has been developed and various new solutions have been used. Surgery is the main treatment for pterygium. Various techniques such as Bare Sclera, Rotational Conjunctival Flap, Limbal Conjunctival Autograft, Amniotic Membrane Graft, and Free Conjunctival Autograft are used for the removal of pterygium. It also seems that the worrisome problem of recurrence has been significantly reduced with newer treatment methods. On the contrary, the use of auxiliary treatments such as mitomycin C, b-radiation, 5-fluorouracil, topical use of interferons, and Avastin are also effective in reducing the recurrence rate.

Corynebacterium ocular infection after Baerveldt glaucoma implant surgery: treatment involving immediate tube withdrawal and temporary subconjunctival tube placement: a case report

BackgroundWe report a case of Corynebacterium endophthalmitis secondary to tube exposure following Baerveldt glaucoma implant surgery that was successfully treated with prompt tube withdrawal and temporary subconjunctival tube placement without removing the glaucoma drainage device.Case presentationA 65-year-old Japanese man with secondary glaucoma underwent glaucoma drainage device surgery with a donor scleral patch graft in the inferonasal quadrant of his right eye. Ten months after surgery, he presented with tube exposure due to dehiscence of the overlying conjunctiva and erosion of the scleral patch graft. Eleven days later, mild inflammation was found in the anterior chamber and anterior vitreous body, with the root of the tube surrounded by a plaque at the site of insertion in the anterior chamber. He was diagnosed with infectious endophthalmitis secondary to tube exposure. Two days later, since medical therapy was ineffective, the tube was withdrawn from the anterior chamber and irrigated with a polyvinyl alcohol-iodine solution, and the tube was tucked into the subconjunctival space. Complete resolution of the infection was achieved 1.5 months later. The tube was reinserted nasally into the anterior chamber and covered with a scleral patch graft and a free limbal conjunctival autograft. Thereafter, there has been no recurrence of infection or tube exposure. Twenty eight months after tube reinsertion, his right best-corrected visual acuity was 20/50 and intraocular pressure was 12 mmHg.ConclusionPrompt tube withdrawal and temporary subconjunctival tube placement followed by tube reinsertion may be effective for endophthalmitis associated with tube exposure after glaucoma drainage device surgery.

Comparison of efficacy of conjunctival autografts using sutures and fibrin glue in patients undergoing pterygium excision surgery

Background: Pterygium is a wing-shaped ocular surface lesion traditionally described as an encroachment of bulbar conjunctiva onto the cornea. Hence; the present study was undertaken for comparing the efficacy of conjunctival autografts using sutures and fibrin glue in patients undergoing pterygium excision surgery. Materials & Methods: 40 patients presenting with the pterygia of various types were enrolled. Patients were divided into 2 groups with 20 patients in each group, for applying sutures and fibrin glue to one group each. Each eye of the patient was considered as one case. Screening of the patient by brief history and general physical examination was done. Diffuse torch light examination for details of the pterygium and to rule out any other gross ocular pathology. Follow-up was done and postoperative findings were compared. Results: Mean duration of surgery of the suture group and the glue group were 31.5 minutes and 18.4 minutes respectively. Significant results were obtained while comparing the mean duration of surgery. Patient discomfort was significantly less in the glue group in comparison to the suture group. Conclusion: From the above results, the authors concluded that the use of fibrin glue to attach the free conjunctival autograft in pterygium surgery produces shorter operating time and less post-operative discomfort as compared to sutures.

Comparison of conjunctival free autograft and Rotational flap technique in primary pterygium surgery: Visual changes and safety profiles

Aims and objectives: To evaluate the postoperative symptomatic comfort, visual changes,complication and rate of recurrence in free conjunctival autograft and rotational flap technique inprimary pterygium surgery. Materials & Methods: This prospective study was conducted in 60 eyesof 60 patients, presented with primary progressive nasal pterygium larger than 1mm causingsymptomatic discomfort, astigmatism and cosmetic disfigurement. Patients were divided into twogroups randomly. In group A, patients with pterygium excision with free conjunctival autograft andgroup B, pterygium excision with rotation flap technique were included. Post-operative day 1symptomatic comfort (symptoms and signs), graft stability, corneal clarity and any complicationwere noted. Visual acuity (VA), auto-refracto keratometer measurements and detailedbiomicroscopic examinations, were performed preoperatively and postoperatively at 1month and 3months. Results: Most of the patients in our study were in the middle age group of 40-49 years(41.6%). Out of 60 patients, 35 were males (58.4%) and 25 were females (41.6%). Patients withoutdoor activities had a higher prevalence of pterygium (78.4%). The incidence of pterygium wasmore in the right eye (60%) than left eye (40%). Of the 60 patients, Grade I, II and III pterygiumwas 20%, 56.7% and 23.3% in group A and 16.7%, 63.3% and 20% in group B respectively. Themean symptomatic score was statistically significantly higher for group A for each factor (P<0.05).In the 3rd month, the overall patient’s satisfaction score was significantly higher in group B(P<0.05). Conclusion: Both surgical techniques were equally effective in terms of visual acuity,astigmatism and recurrence. The patient’s satisfaction score was significantly higher in the rotationflap technique group.

Sutureless Glue Free Versus Sutured Limbal Conjunctival Autografts in Primary Pterygium Surgery.

Surgical excision is the definitive treatment for pterygium. Following excision, conjunctival autograft is usually preferred. Various methods for grafting with sutures, glue or autologous serum from the recipient bed are in use. The objective of this study was to compare surgical outcomes of sutureless glue free conjunctival autograft with sutured (vicryl 8-0) conjunctival autograft in primary pterygium excision. A prospective randomized interventional study was carried out in 100 eyes with primary pterygium. They were divided into two groups for conjunctival graft adhesion; sutureless glue free (group 1; n=50 eyes) and sutured with absorbable (vicryl 8-0) suture (group 2; n=50 eyes). Time taken for surgery, complications, postoperative symptoms and overall satisfaction score were noted. The patients were followed up on day 1, day 14 and 6 weeks after surgery. Recurrence was noted till 1 year after surgery. The mean age was 46.76 ± 11.97 years (group 1) and 47.24±12.76 years (group 2). Group 1 had shorter duration of surgery (p<0.001), less postoperative complaints (p<0.001) and better patient satisfaction (p<0.001) than group 2. Postoperative complications and gain in visual acuity in both the groups were not clinically significant. Recurrence was not significant in both groups until 1 year of follow up. Pterygium surgery with sutureless glue free conjunctival autograft had fewer postoperative complaints and better patient satisfaction than pterygium surgery with sutured conjunctival autograft. The postoperative complications, recurrence were comparable to conventional sutured technique.

Outcome of Infero Temporal Suture Less and Glue Free Conjunctival Autograft in Patients with Pterygium at a Tertiary Care Hospital of Vidarbha Region

Outcome of Infero Temporal Suture Less and Glue Free Conjunctival Autograft in Patients with Pterygium at a Tertiary Care Hospital of Vidarbha Region

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

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.

Glue Free and Suture Free Conjunctival Autograft in Pterygium Excision:A North Indian Perspective

Aim: To study postoperative outcome &amp; related complications of Glue free and suture free conjunctival autograft in pterygium excision in Haryana-A North Indian state. Materials and Method: The present study was conducted at the Department of Ophthalmology, MMIMSR, Mullana (Maharishi Markandeshwar Deemed to be University) in the time period extending between December 2017 and January 2019. 50 eyes of patients of either sex with primary pterygium were selected and pterygium was excised &amp; sutureless &amp; glue free conjunctival autograft was done with patient’s own blood fibrin. Parameters such as mean operating time, presenting complaints, grade, complications &amp; recurrence were observed on postoperative Day 1, Day7, 2 weeks, 1 month, 2 month, 3 month &amp; 6th month. Results: The mean age of the study population was 48.82 + 11.13 years... Out of 50 eyes only 1 (2%) had conjunctival cyst, 2 (4%) graft edema and 3 (6%) had graft displacement, 1(2%) had graft lost, 1(2%) had graft rejection &amp; 1(2%) had recurrence at 6 month follow up. The mean operation time was 24.88 minutes. Regarding type of the pterygium, out of 50 patients 9(18%) were grade 1, 26(52%) were grade 2, 11(22%) were grade 3 and 4(8%) were grade 4. Conclusion: Conjunctival autograt using patients own blood technique is a safe, cheaper, effective, with less surgical time &amp; has minimal postoperative discomfort.

Complications and Recurrence after Pterygium Excision using Mitomycin C Eye Drops versus Sutureless and Glue Free Conjunctival Autograft: A Prospective Study

Introduction: Recurrence is the most common problem with pterygium excision. Various adjunctive methods have been described to decrease the recurrence rate of pterygium. Mitomycin C (MMC) and limbal Conjunctival Autograft (CAG) are most commonly used methods to reduce its recurrence. Aim: To compare the recurrence rate of pterygium and the complications with MMC eyedrops after bare sclera pterygium excision versus sutureless and glue free CAG. Materials and Methods: Total 104 eyes were divided into two groups (A and B) of 52 eyes each. Group A patients underwent bare sclera excision of pterygium followed by 0.01% MMC eye drops BD (twice a day) for five days and Group B patients had sutureless and glue free CAG using oozing blood as tissue adhesive after pterygium excision. The patients were followed-up postoperatively on day 1, day 3, day 7, one month, three months, six months and one year. All the patients were examined for recurrence and complications. Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 16 and student’s t-test was applied for comparison. Results: A total of 104 eyes of 92 patients were divided into two groups (A and B) of 52 each. The mean age of Group A was around 45 year and group B was around 43 years and the difference was statistically insignificant (p&gt;0.05). Total three patients had recurrence in one year of follow-up in group A, out of which first case appeared before the end of 1st month, second before the completion of 3rd month and the third case at the last follow-up. In group B only one case presented with recurrence at 6th month follow-up. The difference between the recurrences in both the groups was statistically insignificant (p&gt;0.05). Short term complications were observed in five patients in group A. One patient had corneal thinning; one had scleral thinning, two patients presented with avascular sclera and one patient with granuloma. In group B, 18 patients with graft retraction, eight with graft oedema, five with sub-conjunctival graft haemorrhage and one with granuloma were observed. All these complications resolved by the time. Long term complications were not observed in any patient of both the groups. Conclusion: This study concluded that the use of MMC eye drops (0.01%) BD or glue free and sutureless CAG after pterygium excision is safe and effective treatment modalities for pterygium.

Profile of Patients Undergoing Pterygium Excision with Suture Free Glue Free Conjunctival Autograft in a Hilly North Indian District

Profile of Patients Undergoing Pterygium Excision with Suture Free Glue Free Conjunctival Autograft in a Hilly North Indian District

Evaluation of the Effectiveness of Rotational Conjunctival Flap Compared to Free Autografting for Ocular Surface Reconstruction after Surgical Removal of Primary Pterygium

Background: pterygium is a fibrovasular lesion of the ocular surface that can display an aggressive clinical behavior and occasionally, threatens the vision. Although there is no consensus on its pathogenesis, recent evidence suggests that is a prolifrative rather than degenerative condition, strongly correlated with exposure to ultraviolet radiation of solar light. Objictive: the purpose of this study was to compare the surgical outcomes when using the technique of conjunctival autograft versus conjunctival rotational flap for reconstruction of ocular surface following primary pterygium excision. Patients and Methds: this study included 20 eyes of 20 patients with primary pterygia attending at the National Eye Center, Rod El Afarag Hospital. Operated eyes were divided into 2 groups, 10 eyes each Group A: included 10 eyes managed by pterygium excision followed by ocular surface reconstruction using rotational conjunctival flap technique. Group B: included 10 eyes managed by pterygium excision followed by ocular surface reconstruction using free conjunctival autograft technique. Results: The better result wase in cases treated by conjunctival autograft group with 10 % recuurence while the higher recurrence rate 20% was seen in cases by rotational conjunctival flap group. Other minor complications were found such as flap retraction in 2 cases of group, buttonhole of the graft in one case in group B, flap edema was in lower incidence than graft edema and no suture granuloma happened in both groups. Conclusion: free conjunctival autograft and rotational conjuctiavl flap showed comparable results, in reducing recuurence rate; they are safe and effective methods of pterygium surgery that produces only few complications.

Comparison between Sutureless and Glue Free versus Sutured Limbal Conjunctival Autograft in Primary Pterygium Surgery

Introduction: To compare and evaluate the safety and efficacy of two surgical techniques for the management of primary pterygium.&#x0D; Materials &amp; Methods: The study included 176 eyes of 176 patients with primary pterygium. The mean age was 49 ± 12 years (range 24–74 years). Simple excision under local anesthesia was performed followed by closure of the bare sclera by suture less and glue free conjunctival autograft in 76 eyes of 76 patients (group 1), versus the conventional method of a sutured conjunctival autograft in 100 eyes of 100 patients (group 2).&#x0D; Results: The pterygium recurrence rate was 6% for group 1, 8% for group 2. Graft dehiscence occurred in 4 eyes out of 50 (8%) in group 1. Graft retraction occurred in 6 (12%) out of 50 eyes for group 1 versus 6 eyes (6%) in group 2. Pyogenic granuloma occurred in 3 (3%) eyes out of 100 in group 2. No other serious complications were noted. At the 3 week visit the overall patient satisfaction score was statistically significantly higher for group 1 (P &lt; 0.002) compared to group 2. At 3 months postoperatively, the gain in uncorrected visual acuity (UCVA) ranged from 0.2 to 0.5 Log MAR in 10 eyes.&#x0D; Conclusion: Sutureless and glue free conjunctival autograft technique is easy, safe, effective, prevents potential adverse reactions encountered with the use of foreign materials. This technique has an acceptable pterygium recurrence rate that is comparable to conventional sutured conjunctival autograft for primary pterygium.&#x0D; Medicine Today 2018 Vol.31(1): 1-8

Primary nasal pterygium excision with sutureless and glue-free technique of conjunctival autograft

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.&#x0D; 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.&#x0D; 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. &#x0D; 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.

The outcome of sutureless glue-free conjunctival autograft for recurrent pterygium

Aim To evaluate and analyze the surgical outcome of suture-free, glue-free conjunctival autograft after excision in recurrent pterygium. Patients and methods A retrospective study of 23 eyes of 21 patients with recurrent pterygium was done, and excision was performed in all eyes. Free conjunctival autograft was taken from superior quadrant of the same eye, and 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 48 h. Postoperatively, patients were put on topical eye drops (tobramycin and dexamethasone) for 6 weeks. All patients were examined after 48 h and followed for 1, 4, 12, and 24 weeks for postoperative results and complications. Results Of 23 eyes, only seven (30.43%) had subconjunctival hemorrhage, three (13.04%) had graft recession, and two (08.69%) eyes had totally dislodgement of the graft and three (13.04%) eyes had partial displaced. Overall, four eyes had intraocular pressure more than 25 mmHg after 48 h of operation, and two of them took antiglaucoma drugs to control intraocular pressure during the follow-up period. At the end of follow-up time, only three (13.04%) eyes with graft recession were observed. Recurrence of pterygium was noted in one case. Conclusion Suture-free, glue-free conjunctival autograft after excision in recurrent pterygium is easy, simple, safe, fast, and effective procedure with acceptable recurrence rate.

Outcome of Sutureless and Glue free Conjunctival Autograft in primary pterygium Surgery

Outcome of Sutureless and Glue free Conjunctival Autograft in primary pterygium Surgery

Results of an Adaptive Surgical Approach for Managing Late Onset Hypotony After Trabeculectomy With Mitomycin C.

The objective of this study is to investigate the results of an adaptive approach of bleb revision surgery for late onset hypotony after trabeculectomy with mitomycin C because of bleb leakage and/or scleral melting. A total of 29 eyes of 27 patients, aged 63.8±11.7 years with hypotony maculopathy [intraocular pressure (IOP), ≤6 mm Hg] because of late onset bleb leakage and/or scleral melting after trabeculectomy with mitomycin C in which minimally invasive transconjunctival suturing of the scleral flap was impossible were enrolled in this retrospective interventional case series. External bleb leakage was seen in 16 eyes, 11 eyes suffered from scleral melting. Because of the intraoperative findings regarding appearance of conjunctiva and sclera 4 different surgical approaches were used: (1) bleb excision (in case of external leakage) and conjunctival reapproximation, (2) bleb excision and free conjunctival autografting, (3) human donor scleral patch grafting (in case of scleral flap defect) with conjunctiva reapproximation and (4) combined conjunctival and scleral patch grafting. Outcome measures were IOP and visual acuity (VA) development over time. Data analysis comparing changes in the parameters (IOP and VA) before and after bleb revision surgery was carried out using the paired t test. Changes in IOP and VA were analyzed over 9.3±8.3 months (range, 1.1 to 36.5 mo). IOP increased from 4.0±1.8 mm Hg, (P<0.001) before revision surgery to 13.1±4.1 mm Hg at 3 months after revision and 12.6±3.8 mm Hg at last follow-up visit, showing no significant difference in IOP between 3 months post revision and at the last documented patients' follow-up visit (P=0.28). The VA before revision surgery (0.42±0.28 logMAR) significantly increased (P=0.05) 3 months after revision (0.32±0.23 logMAR) and remained stable (P=0.65) until the last follow-up visit (9.3±8.3 mo; range, 1.1 to 36.5) (0.35±0.32 logMAR). In patients with hypotony an adaptive approach of bleb management shows good results both in terms of IOP control and improvement in VA.

Recurrence Rate in Primary Pterygium Managed by Surgical Excision of Pterygium with Application of Mitomycin-C over Bare Sclera and Free Conjunctival Autografting

Background: To study recurrence rate in 50 cases of primary pterygium managed by surgical excision of pterygium along with application of mitomycin-C 0.02% over bare sclera for 2 minutes and ipsilateral free conjunctival autografting. Methods: This prospective observational study was carried out on 50 patients of primary pterygium operated between 25.05.2016—10.08.2016. Pterygium excision was done, 0.02% mitomycin-C was applied over bare sclera for 2 minutes and ipsilateral free conjunctival autografting was done using sutures. Patients were followed up for a mean period of 13.27 months for recurrence. Results: 55 eyes of 50 patients were operated by above technique by a single surgeon1. Three (3) patients were lost in follow up. In an average follow-up time of 13.27 months, recurrence was found in only 1 case (1.92%). No serious side effects were observed in this study. Conclusions: Primary Pterygium managed by excision of pterygium followed by intraoperative mitomycin-C application and conjunctival autografting is an easy, reproducible and cost effective method which helps in reducing recurrence with minimal complications.