Omkar Jagdish Telang1, Meera Suresh Joshi2, Bindi Parekh3
BACKGROUND
Pterygium is a degenerative condition of the subconjunctival tissue, which proliferates as vascularised granulation tissue to invade the cornea, destroying the superficial layers of stroma and Bowman’s membrane, the whole being covered by conjunctival epithelium.1 It can vary from small, atrophic pterygium to large, advancing pterygium obscuring the optical center of the cornea. The natural history of the condition is variable, prolonged static periods do exist. Anti-inflammatory drugs and lubricants have an important role in minimising the patient's discomfort, but it does not cure the disease. Hence, surgical excision of the pterygium is the most widely accepted treatment for pterygium with the main aim to reduce the recurrence of the lesion.2 Many surgical treatments have been described over the years.
The aim of the study is to compare postoperative outcome using 2 different techniques of conjunctival autograft after pterygium excision with sutures vs. without sutures using autologous blood.
MATERIALS AND METHODS
The study included 50 eyes of 50 patients with primary pterygium. They were randomly divided into two groups- In group 1, 25 eyes underwent conjunctival autograft with patient’s own blood followed by bandaging for 48 hours; in group 2, 25 eyes underwent conjunctival autograft with 10-0 monofilament nylon sutures followed by patching the eye for 24 hours. Patients were followed up postoperatively on 2nd day, at 1 week, 2 weeks and 4 weeks. All surgeries were done by same surgeon. Patient comfort, operating time, graft complications, pre and post-surgery visual acuity and astigmatism were studied.
Design- Prospective and comparative study.
RESULTS
Postoperative symptoms were less in group 1 than group 2. The operative time was significantly less in group 1 (21-30 minutes) than group 2 (31-40 minutes). Complications like graft oedema, graft retraction and graft dehiscence were present in group 1, however, the difference was not statistically significant. Also, change in astigmatism was noted postoperatively along with improvement in best corrected visual acuity. The patients need to be padded after surgery for 48 hours in group 1 compared to 24 hours in group 2.
CONCLUSION
Thus, autologous blood is a useful method for graft fixation in pterygium surgery with shorter operating time and less postoperative discomfort.
KEYWORDS
Pterygium Excision, Conjunctival Autograft, Autologous Blood, Sutures.
