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

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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Recurrence Rate and Graft Stability With Fibrin Glue Compared With Suture and Autologous Blood Coagulum for Conjunctival Autograft Adherence in Pterygium Surgery

Cornea ◽

10.1097/ico.0000000000001270 ◽

2017 ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

Rituparna Maiti ◽

Somnath Mukherjee ◽

Debasish Hota

Keyword(s):

Recurrence Rate ◽

Fibrin Glue ◽

Autologous Blood ◽

Conjunctival Autograft ◽

Pterygium Surgery

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Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

International Eye Research ◽

10.18240/ier.2021.03.01 ◽

2021 ◽

Vol 2 (3) ◽

pp. 123-126

Author(s):

Tian-Yu Wang ◽

◽

Min Yang ◽

Yi Zhang ◽

Zhao-Yang Wang ◽

...

Keyword(s):

Recurrence Rate ◽

Case Series ◽

Operation Time ◽

Recurrence Time ◽

Conjunctival Autograft ◽

Long Term Follow Up ◽

Pterygium Surgery ◽

Limbal Conjunctival Autograft ◽

Primary Pterygium

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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Effect of tissue glue versus suture in pterygium surgery in a tertiary care center of North-East India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20212223 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1598

Author(s):

Monalisa Deori ◽

J. J. Kuli ◽

Bharati D. Boruah

Keyword(s):

Fibrin Glue ◽

Tertiary Care ◽

Operating Time ◽

Care Hospital ◽

Conjunctival Autograft ◽

Tissue Glue ◽

Suture Group ◽

Pterygium Surgery ◽

Limbal Conjunctival Autograft ◽

Postoperative Discomfort

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.

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Recurrence Rate Using Fibrin Glue-Assisted Ipsilateral Conjunctival Autograft in Pterygium Surgery: 2-Year Follow-up

Cornea ◽

10.1097/ico.0b013e3181d5d96d ◽

2010 ◽

Vol 29 (11) ◽

pp. 1211-1214 ◽

Cited By ~ 9

Author(s):

Vincenzo Sarnicola ◽

Lorenzo Vannozzi ◽

Paolo Alfonso Motolese

Keyword(s):

Recurrence Rate ◽

Fibrin Glue ◽

Conjunctival Autograft ◽

Pterygium Surgery

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Twelve-Year Outcomes of Pterygium Excision with Conjunctival Autograft versus Intraoperative Mitomycin C in Double-Head Pterygium Surgery

Journal of Ophthalmology ◽

10.1155/2015/891582 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Tommy C. Y. Chan ◽

Raymond L. M. Wong ◽

Emmy Y. M. Li ◽

Hunter K. L. Yuen ◽

Emily F. Y. Yeung ◽

...

Keyword(s):

Mitomycin C ◽

Recurrence Rate ◽

Clinical Assessment ◽

Original Study ◽

Conjunctival Autograft ◽

Significant Difference ◽

Pterygium Surgery ◽

Pterygium Excision ◽

Double Head

Purpose. The study aims to compare the long-term outcome of conjunctival autograft (CAU) and mitomycin C (MMC) in double-head pterygium surgery.Methods. This is a follow-up study of a comparative interventional trial. Thirty-nine eyes of the 36 patients with double-head pterygium excision in the original study 12 years ago were recruited for clinical assessment. Seven out of the 36 patients were lost. In the original study, each eye with double-head pterygium was randomized to have pterygium excision with CAU on one “head” (temporal or nasal) and MMC on the other “head.” All patients were invited for clinical assessment for conjunctival bed status and the presence of pterygium recurrence in the current study.Results. There was no significant difference between the size, morphology, and type of pterygium among the two treatment groups. The recurrence rate of CAU group and MMC group 12 years after excision was 6.3% and 28.1%, respectively (P=0.020). Among eyes without recurrence, the conjunctival bed was graded higher in the MMC group than the CAU group (P=0.024).Conclusion. The use of conjunctival autograft has a significantly lower long-term recurrence rate than mitomycin C in double-head pterygium surgery.

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