Harpal Singh1, Sagarika Laad2, Rajesh Sripat Pattebahadur3, Pranav Saluja4, Parag Ramnani5
Pterygium is a degenerative and hyperplastic condition of conjunctiva. In this, subconjunctival tissue proliferates as vascularised granulation tissue, thus invading the cornea and destroying the superficial stroma and Bowman’s membrane. It varies from small asymptomatic lesion to large, rapidly growing lesion, thus leading to impairment of vision. Pterygium occurs more frequently between 30 degrees latitude north and south of the equator called as “pterygium belt.” The most challenging situation after pterygium excision is the recurrence of the pterygium. Many techniques had been used, but none of them is universally accepted due to variable recurrence rate.
The aim of the study is to compare the two modalities of treatment in pterygium excision with postoperative outcomes.
MATERIALS AND METHODS
A comparative study was conducted from July 2016 to August 2017 in the Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal (M.P.). Total 50 patients with primary nasal pterygium of grade 2 or more were enrolled from eye outpatient department. The patients were randomly divided into two groups for pterygium excision with conjunctival autografting using either autologous blood (group A) or sutures (group B). Two groups were compared for postoperative discomfort, recurrence and graft displacement.
Out of 50 patients, 28 were in group A and 22 were in group B. Maximum numbers of patients were involved in outdoor activities. In comparison to autologous blood technique, postoperative discomfort was more in suture group after pterygium excision. In group A, the graft displacement was found in 2 (7.1%) patients, whereas in group B, there was no graft displacement seen. While in group B2 (9.1%) patients had granuloma formation. The recurrence of pterygium was high (22.7%) in group B as compared to group A (3.6%). There was a significant correlation between rate of recurrence and type of surgery (P value <0.05).
Fixing of graft after pterygium excision by autologous blood is a better, cost-effective technique and associated with less complications when compared with graft fixation by sutures. Thus, this study has been conducted to compare the two different techniques of pterygium surgery.