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

2020 ◽  
Vol 17 (2) ◽  
pp. 227-232
Author(s):  
Fariha S. Wali ◽  
Muhammad Jawed ◽  
Rafeen Talpur ◽  
Naeemullah Shaikh ◽  
Shehnilla Shujaat ◽  
...  

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.

2021 ◽  
Vol 2 (3) ◽  
pp. 123-126
Author(s):  
Tian-Yu Wang ◽  
◽  
Min Yang ◽  
Yi Zhang ◽  
Zhao-Yang Wang ◽  
...  

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.


Author(s):  
Monalisa Deori ◽  
J. J. Kuli ◽  
Bharati D. Boruah

Background: Pterygium is a triangular fibrovascular tissue of conjunctiva encroaching on to the cornea. Currently, conjunctival autograft technique after excision is reported as the most suitable and safest method. The autograft transplantation can be done either with the help of suture or tissue adhesives. Objective of the study was to evaluate the effects of tissue glue versus suture in limbal conjunctival autograft transplantation among the patients undergoing pterygium excision.Methods: A prospective study was carried out in a tertiary eye care hospital. 60 patients with primary pterygium underwent limbal conjunctival autograft transplantation. They were enrolled into two groups, group-A (tissue glue, N=30) and group-B (suture group, N=30). Operative time, postoperative patient comfort and recurrence of pterygium were assessed. The patients were followed-up for 6 months.Results: The mean surgical time in fibrin glue group (23.56±2.80) was significantly less compared to suture (30.78±2.20) group with p<0.001. Postoperative discomfort in terms of pain, lacrimation and foreign body sensation was significantly less with fibrin glue in comparison to suture (p<0.05). Postoperative complications like redness, subconjunctival hemorrhage, graft edema and graft retraction were significantly more in suture group during late postoperative period. Recurrence of pterygium was noted in two patients (6.67%) in suture group and one patient in fibrin glue group (3.33%) which was not statistically significant (p>0.005).Conclusions: The use of fibrin glue for securing the limbal conjunctival autograft in pterygium surgery significantly reduces the operating time and postoperative discomfort.


2019 ◽  
Vol 10 (1) ◽  
pp. 28-31
Author(s):  
Md Anwar Hossain Khan ◽  
AHM Zahirul Islam Biswas ◽  
Md Mosharrof Hossain

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


2017 ◽  
Vol 27 (4) ◽  
pp. 466-469 ◽  
Author(s):  
Luis F. Mejía ◽  
Juan P. Santamaría ◽  
Miguel Cuevas ◽  
Andrea Córdoba ◽  
Sergio A. Carvajal

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.


2021 ◽  
Vol 23 (4) ◽  
pp. 319-323
Author(s):  
Pragati Gautam Adhikari ◽  
Sagun Narayan Joshi

This study was done to evaluate the outcome of pterygium excision with inferonasal conjunctival autograft at a tertiary eye care centre. Retrospective analysis of medical records of primary pterygia patients operated by a single surgeon between 2017 to 2020 were analyzed. A total of 43 patients who met the inclusion criteria were included in the study. The demographic variables, along with size of pterygium and recurrence over a period of six month follow up was noted. The mean age of patients was 46.97 years (29-74 years). The mean size of pterygium was 3.17 mm. Recurrence was seen in 3 eyes over a period of 6 months. Graft edema was observed in 11 patients and graft hemorrhage along with congestion was seen in 8 cases which resolved over a 3 weeks follow up period. Mild conjunctival scarring was seen over donor area in 5 of the eyes. Pterygium excision with inferior conjunctival autograft is an effective alternative technique to superotemporal autograft technique.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Tarek Roshdy Elhamaky ◽  
Ahmed Mohammed Elbarky

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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