Pterygium surgery with conjunctival autograft with sutures versus suture-less and glue-less: A prospective comparative study

Authors : Prasanna Jit Das, Prasanna Jit Das, Dharmendra Kumar, Dharmendra Kumar, Harish Goswami, Harish Goswami, Saura Kamal Dutta, Saura Kamal Dutta

DOI : 10.18231/j.ijooo.2019.047

Volume : 5

Issue : 4

Year : 2019

Page No : 194-200

Introduction: A pterygium is a triangular ‘wing-like’ growth consisting of conjunctival epithelium and
hypertrophied subconjunctival connective tissue that occurs nasally and/or temporally in the palpebral
fissure and encroaching over to the limbus and then to the cornea. Actual pathogenic mechanisms of
this condition is unknown hence remains an enigma in ophthalmlogy.
This degenerative thick and vascular conjunctival and sub- conjunctival tissue is triangular shape d most
commonly found on the nasal side and also it progressively destroys the corneal bowman’s layer and
superficial layer of the stroma. It is most commonly seen in the tropical country, implicating sunlight
and UV radiation as a probable cause.
Objective: To compare the post-operative outcome of primary pterygium excision followed by autologous
limbal conjunctival grafting with application of sutures vs suture-less and glue-less.
Materials and Methods: This study is a prospective comparative and interventional case study. 50 eyes
with primary pterygium are selected. Patients were divided into two equal groups with 25 number of eyes
in each group.
a) Group- I = suturing of auto graft with (10-0) nylon sutures
b) Group- II = fixing of auto graft without sutures i.e. Suture-less and without glue i.e. glue-less.
Results: The average operative time for Group- I was 26.44 8.19 min and for Group- II was 20.52 5.13
min (p-value < 0> in 4 eyes i.e. 16% (p-value <0> more in Group-I than Group-II from 1st Postoperative day. The duration of which lasted in Group- I for
< 3> symptom free than the Group - I from the first postoperative day onwards. Post operatively in Group- 1
Graft oedema was seen in 5 eyes i.e.20% and in Group- II= 3 eyes i.e.12% which resolved within 2week.
In Group -I = 2 patients i.e. 8% had graft lost and 1-patient i.e. 4% had recurrence which is statistically
insignificant.
Conclusion: Lots of surgical procedures has been tried for the treatment of primary pterygium this
technique of fixing the auto-graft without sutures i.e. suture-less and without glue i.e. glue-less is rather
an evolving one getting preference by the modern surgeons worldwide as it is less time consuming, more
convenient in the sense of avoiding complication of sutures and glues thereafter the related problems of the
sutures and glues, moreover it’s cost effectiveness is an advantage.

Keywords: Primary pterygium, Pterygia, Conjunctival autograft, Suture- less, Glue- less.


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