A Study on Sutureless and Glue-free Conjunctival Autograft in Pterygium Surgery in A Tertiary Medical College Hospital

Background: Foreign material 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 hypersensivity 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. Materials & Methods: This study was conducted at Jahurul Islam Medical college Hospital, Bajitpur, Kishoregonj from August 2016 to April 2018. Fifty cases with unilateral primary pterygium were selected for the study. The operation was done under local anaesthesia. After pterygium excision and fashioning of the autologus conjunctival graft, the recipient bed is allowed to achieve natural haemostasis and relative dessication before graft placement. Excessive haemorrhage in the graft bed is temponaded. Graft adherence and positioning is examined after surgery. Results: A total of 50 eyes of 50 patients mean age at the time of surgery was 40.5±10.3 years ranged from 17 to 70 years, with a female to male ratio was 1:1.94, underwent sutureless glue-free autologus conjuntival graft after pterygium excision. Mean graft area was 24(1.5) mm2. The patients were followed up for 4 months. Cosmesis was excellent in all cases and there were no intra- or post-operative complications requiring further treatment. Conclusion: This simple technique for pterygium surgery may prevent potential adverse reactions encountered with the use of foreign materials and this small series provided safe and comparable results to current methods. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 28-31

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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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Outcomes of Vertical Split Conjunctival Autograft Using Fibrin Glue in Treatment of Primary Double-Headed Pterygia

Journal of Ophthalmology ◽

10.1155/2018/9341846 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Tarek Roshdy Elhamaky ◽

Ahmed Mohammed Elbarky

Keyword(s):

Fibrin Glue ◽

Fibrous Tissue ◽

Effective Technique ◽

Normal Appearance ◽

Conjunctival Autograft ◽

Donor Area ◽

Good Cosmetic ◽

Pterygium Surgery ◽

Pterygium Excision

Purpose. To evaluate the efficiency of pterygium excision with the vertical split conjunctival technique using fibrin glue in treatment of primary double-headed pterygia. Patients and Methods. 15 eyes of 15 patients with primary double-headed pterygia that underwent vertical split conjunctival autograft pterygium surgery were retrospectively reviewed. Recurrence was defined as fibrovascular proliferation over the limbus onto the cornea. Results. The patients’ mean age was 36.92 ± 10.8 years. At 12-month follow-up, recurrence was not seen in any cases. Regarding postoperative cosmetic grading, grade 1 (the appearance of the operated site is not different from the normal appearance) was found in 12 eyes (80%) and grade 2 (some fine episcleral vessels in the excised area extending up to but not beyond the limbus and without fibrous tissue) was found in 3 eyes (20%). None of the cases showed conjunctival scarring or fibrosis at the conjunctival donor area. Preoperative Sim K astigmatism at the central 3 mm and BCVA were 3.05 ± 1.5 diopters (D) and 0.64 ± 0.26 logMAR, which improved significantly to 1.15 ± 0.84 D and 0.26 ± 0.18 logMAR at 12-month follow-up postoperatively, respectively. Conclusion. Vertical split conjunctival autograft using fibrin glue is an effective technique with good cosmetic results and low to no recurrence for primary double-headed pterygia treatment. This trial is registered with NCT03507283.

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Outcome of pterygium surgery by using conjunctival autograft attachment with fibrin glue: a prospective study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205831 ◽

2020 ◽

Vol 9 (1) ◽

pp. 134

Author(s):

Happy Kaur ◽

Babar Maqbool ◽

Manpreet Kaur

Keyword(s):

Prospective Study ◽

Fibrin Glue ◽

Operating Time ◽

Treatment Modalities ◽

College Hospital ◽

Medical College ◽

Department Of Ophthalmology ◽

Pterygium Surgery ◽

One Year ◽

A Prospective Study

Background: Pterygium is a degenerative condition of sub conjunctival tissues that proliferates as vascularised granulation tissue to invade cornea. Treatment modalities may be medical or surgical. Objectives were to asses results of pterygium surgery in patients with pterygium, in terms of operative time, post-operative symptoms, overall graft success and post-operative complications conducted at government medical college, hospital, Jammu during one year.Methods: Prospective study conducted on 25 patients by using fibrin glue over a period of one year in upgraded department of ophthalmology at GMC Jammu.Results: Mean operating time was 23.20 minutes by using fibrin glue, severity of post-operative symptoms were less. Graft successfully attached in all cases.Conclusions: Present study concluded that use of fibrin glue associated with less operating time and less post-operative discomfort in terms of severity and duration

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Pterygium excision with suture-less and glue-free conjunctival autograft

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i2.579 ◽

2020 ◽

Vol 17 (2) ◽

pp. 227-232

Author(s):

Fariha S. Wali ◽

Muhammad Jawed ◽

Rafeen Talpur ◽

Naeemullah Shaikh ◽

Shehnilla Shujaat ◽

...

Keyword(s):

Operating Time ◽

Operation Time ◽

Institutional Review Board ◽

Simple Method ◽

Conjunctival Autograft ◽

Institutional Review ◽

Pterygium Surgery ◽

Pterygium Excision ◽

Operative Recovery ◽

Limbal Conjunctival Autograft

Introduction: Pterygium excision is a commonly encountered surgery with different methods being used. These procedures range from simple excision to use of grafts. Limbal conjunctival autograft is currently the most popular surgical procedure. The most common method of autograft fixation is suturing. But it has its own drawbacks like increased operating time, post-operative discomfort, inflammation, buttonholes, necrosis, giant papillary conjunctivitis, scarring, and granuloma formation. Glue is widely used due to many advantages like easy fixation of the graft, shorter operation time, and reduction in complications and post-operative discomfort but at the same time has some disadvantages also like high cost, the risk of transmission of infectionsand inactivation by iodine preparations. Purpose: In the following study, we describe a simple method of accomplishing conjunctival autograft adherence during pterygium surgery avoiding possible complications associated with the use of fibrin glue or sutures. Design: Prospective study. Method: We used conjunctival autograft, which was not sutured or glued to the scleral bed. The fibrin formed from the oozing blood was used to get the graft adhesion to the scleral bed. This study was approved by institutional review board, and written consent form was taken from each participant. Results: The suture-less and glue-free conjunctival autograft was found to have excellent results in terms of surgical outcome as well as post-operative recovery. In addition, risk of side effects related to sutures and glue was eliminated. Conclusion: Suture-less and glue-free conjunctival autograft is a new, easy, and cheaper technique for the management of pterygium.

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Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

Journal of Surgical Sciences ◽

10.3329/jss.v22i2.44075 ◽

2020 ◽

Vol 22 (2) ◽

pp. 110-117

Author(s):

Md Mahmudul Islam ◽

Khondkar AK Azad ◽

Md Aminul Islam ◽

Rivu Raj Chakraborty

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Chest Trauma ◽

Road Traffic ◽

Tube Thoracostomy ◽

Rib Fracture ◽

Medical College Hospital ◽

College Hospital ◽

Medical College ◽

The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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