Sutureless and glue-free conjunctival autograft in pterygium surgery: a case series

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

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Sutureless and Glue-free Conjunctival Autograft in Pterygium Surgery: A Case Series

TAJ Journal of Teachers Association ◽

10.3329/taj.v32i2.44900 ◽

2020 ◽

Vol 32 (2) ◽

pp. 56-61

Author(s):

Md Ameenur Rashid Akanda ◽

Yousuf Ali ◽

Sharmin Ferdousi

Keyword(s):

Fibrin Glue ◽

Case Series ◽

Simple Method ◽

Conjunctival Autograft ◽

Uncorrected Visual Acuity ◽

Snellen Chart ◽

Pterygium Surgery ◽

Materials Used ◽

Foreign Materials ◽

Graft Shrinkage

Foreign materials used in ocular surface surgery may lead to local complications such as discomfort, scarring, or infection. Plasma-derived products such as fibrin glue may produce possible hypersensitivity reactions whereas the risk of viral transmission remains. We describe a simple method of achieving conjunctival autograft adherence during pterygium surgery avoiding potential complications associated with the use of fibrin glue or sutures. Pterygium excision with limbal conjunctival autografting without using glue or sutures was performed in all the patients followed by bandaging for 24 hours. The patients were followed up post operatively on 2nd day, 1 week, 1 month, 3 month and 6 months. They were examined for haemorrhage, wound gape, graft shrinkage, chemosis, graft dehiscence, recurrence or any other complications. Total 100 cases were included in this case series. Patient age in ranged from 23 to 78 years (mean 50. 08 ± 12.76 years). Surgical Time was (in Minutes) from 20-28; mean & SD 23.76 ± 1.89. Total graft dehiscence occurred in 1 eye (1%), graft retraction in 12 eyes (12%) and recurrence was seen in 1 eye (1%). At 3 month postoperatively, the gain in uncorrected visual acuity ranged from 2-3 line in Snellen chart in 13 eyes. No other complication was noted. This simple technique for pterygium surgery may prevent potential adverse reactions encountered with the use of foreign materials and in this case series provided safe and comparable results to current methods. TAJ 2019; 32(2): 56-61

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Pterygium Surgery with Conjunctival Autograft Fixation Using Bipolar Electrocauterization

European Journal of Ophthalmology ◽

10.1177/1120672120965488 ◽

2020 ◽

pp. 112067212096548

Author(s):

Fernando Quadros Costa ◽

Ricardo Quadros Costa ◽

José Bonifácio Barbosa ◽

José Álvaro Pereira Gomes

Keyword(s):

Outcome Measure ◽

Intraoperative Complications ◽

Case Series ◽

Bulbar Conjunctiva ◽

Complication Rates ◽

Safe Procedure ◽

Conjunctival Autograft ◽

Pterygium Surgery ◽

The Mean

Purpose: To report a case series of pterygium surgery with conjunctival autograft fixation using bipolar electrocautery. Design: A noncomparative, retrospective, interventional case series of pterygium surgery with follow-up longer than 12 months to assess recurrence and other complication rates. Participants: Fifty-six eyes of 37 patients were treated between April 2011 and January 2018, either for primary ( n = 53 cases) or recurrent ( n = 3 cases) pterygia. Intervention: After pterygium excision, free conjunctival grafts from the inferior bulbar conjunctiva of the same eye were harvested and fixated with the use of bipolar electrocautery. Main outcome measure: Recurrence of the pterygium and complications. Results: The mean follow-up was 41 months (range 12 to 81 months). There were no intraoperative complications. Recurrence of the lesion was seen in three eyes (5.36%). There were no other postoperative complications such as graft detachment, or formation of dellen or granulomas. Conclusion: Conjunctival autograft fixation using bipolar electrocautery seems to be a fast, costly and safe procedure that can be applied in most cases of pterygium surgery.

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Comparison of 4 Techniques for Limbal-Conjunctival Autograft Fixation in Primary Pterygium Surgery

European Journal of Ophthalmology ◽

10.5301/ejo.5000924 ◽

2017 ◽

Vol 27 (4) ◽

pp. 466-469 ◽

Cited By ~ 4

Author(s):

Luis F. Mejía ◽

Juan P. Santamaría ◽

Miguel Cuevas ◽

Andrea Córdoba ◽

Sergio A. Carvajal

Keyword(s):

Recurrence Rate ◽

Fibrin Glue ◽

Ocular Inflammation ◽

Postoperative Patient ◽

Patient Discomfort ◽

Conjunctival Autograft ◽

Significant Difference ◽

Fixation Techniques ◽

Pterygium Surgery ◽

Limbal Conjunctival Autograft

Purpose To compare 4 limbal-conjunctival autograft fixation techniques—conventional suture, commercial fibrin glue, autologous fibrin glue, and cautery—in primary nasal pterygium surgery. Methods This is a retrospective and descriptive study. The postoperative patient discomfort, graft edema, ocular inflammation, and other complications of 4 limbal-conjunctival autograft fixation techniques in primary nasal pterygium surgery were evaluated. Results Postoperative patient discomfort was significantly lower with the sutureless techniques (p<0.001), with fixation with cautery having the lowest rate of discomfort. Graft edema and ocular inflammation during the early postoperative period were significantly higher when fibrin glue techniques were used (p<0.001). The recurrence rate did not show a statistically significant difference (p = 0.682) among the 4 groups. Conclusion In primary nasal pterygium surgery, limbal-conjunctival autograft fixation using cautery is the technique with the lowest postoperative discomfort rate and without a statistically significant increase in recurrence rate when compared to conventional suture and fibrin glue techniques.

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