Comparison of Pterygium Excision with Auto-Grafting Using Suture Vs Suture less, Glue Free (Burial Technique)

Abstract

Objective: To compare the efficacy and safety of suture less glue free limbal conjunctival auto
graft and conventional sutured auto graft for the management of primary pterygium.
Methods: The study was conducted in Department of Ophthalmology, in Nishtar Hospital on 96
patients with primary nasal pterygium. Patients aged between 25 to 50 years with primary
pterygium, Both gender and having pterygium covering ≥ 2 mm of cornea were included in the
study. Patients with history of systemic or neurological deficit, Ocular trauma, pseudopterygium,
Recurrent pterygium, Ocular surface disorder, pregnancy and pterygium covering less than 2 mm
of cornea were excluded. Group A was consist of 48 eyes underwent sutureless and glue free
limbal conjunctival autograft and Group B was also consist of 48 eyes underwent free limbal
conjunctival autograft with suturing. Informed consent was taken. A through ocular examination
including visual acuity, fluoresce in staining, keratometry, refraction, ocular movements, and slit-
lamp examination was done. Post-operatively a pressure eye patch was applied. Analgesia was
prescribed two times daily. All patients were followed up after 48 h, weekly for one month then for
3, 6, 9,12 and 24 months postoperatively. The postoperative outcomes noted were the recurrence
rate which was defined as fibro vascular proliferation invading the cornea more than 1.5 mm at the
site of previously excised pterygium, graft dehiscence, graft retraction, granuloma and dellen.
Results: Age range in this study was from 25 to 50 years with 19 (39.6%) in 25-35 years age
group, 16 (33.3%) in 36-45 years and 13 (27.1%) in >45 years in group A while15( 31.3%) in 25-35
years, 20 (41.7%) in 36-45 years and 13 (27.1%) in > 45 years in Group B. No difference regarding
outcome was seen in both groups. Recurrence rate was (6.3% in group A versus 6.3% in group B,
p=1.000), graft dehiscence (4.2% versus 0%,p=0.153), graft retraction (8.3% versus 6.3%,
p=0.694), granuloma (0% versus 6.35%, p=0.557) and dellen was (2.1% versus 4.2%, p=0.557).
Conclusions: Suture-less and glue free limbal conjunctival autograft is safe, effective,
economical, and its surgical outcomes following primary pterygium surgery are comparable to
conventional suture limbal conjunctival autograft with lower post-operative suture related
complications.