EFFICACY OF SUTURELESS AND GLUE FREE LIMBAL CONJUCTIVAL AUTOGRAFT FOR

PRIMARY PTERYGIUM SURGERY

Dr. Nitesh NarayenCornea and Refractive Surgeon

Maxivision Eye HospitalsSomajiguda, Hyderabad

THE AUTHOR HAS NO FINANCIAL INTEREST IN THE MATERIALS PRESENTED IN THIS POSTER

OBJECTIVE

• To study the efficacy and complications of sutureless and glue free limbal conjuctival autograft for the management of primary pterygium over a period of 1 year.

MATERIALS AND METHODS

• This was a retrospective case series and patients who were operated between December 2012 and June 2013 were analysed.

• 50 eyes of 48 patients were included in the study.

MATERIALS AND METHODS

• All eyes were operated by the same surgeon.

• Pterygium excision with limbal conjuctival autograft without using glue or sutures was performed in all patients followed by bandaging for 12 hours.

MATERIALS AND METHODS

• The patients were followed up post operatively on 1st day, 1 week, 6 weeks, 6 months and 12 months

• They were examined for hemorrhage, wound gape, graft shrinkage, chemosis, graft dehiscence, recurrence or any other complication.

RESULTS

• The mean age of the patients was 48.27±13.74 years ( range 19-77 years).

• 50% of which were males.

• The average follow up was 16.90±5.21 months.

• 5 patients had a line of improvement in UCVA.

46

2 2

PTERYGIA

Primary nasal pterygiumBiheaded pterygiumCystic pterygium

RESULTS

COMPLICATION N0. OF EYES

TOTAL GRAFT DEHISCENCE 1 (2%)

PARTIAL GRAFT RETRACTION 2 (4%)

OVER-RIDING GRAFT ONTO THE CORNEA

1 (2%)

PARTIAL RECURRENCE IN BIHEADED PTERYGIUM

1 (2%)

GRAFT EDEMA 3 ( 6%)

COMPLICATIONSPARTIALLY RETRACTED GRAFT ( 2 EYES)

OVER RIDING GRAFT ( 1 EYE)

COMPLICATIONSPARTIAL RECURRENCE( 1 EYE)

GRAFT EDEMA ( 3 EYES)

LITERATURE REVIEW

Efficacy of sutureless and glue free limbal conjuctival autograft for primary pterygium surgery. Malik KP et al, Nepal Ophthalmol. 2012 Jul-Dec;4(2):230-5. • A prospective interventional case series was

carried out in 40 consecutive eyes with primary nasal pterygium.

• Total graft dehiscence occurred in 2 eyes (5%), graft retraction in 3 eyes (7.5%) and recurrence was seen in 1 eye (2.5%).

DISCUSSION

• The presence of sutures to place CLAG can cause prolonged wound healing and fibrosis.

• Fibrin glues currently manufactured from human plasma theoretically carry the risk of transmissible diseases.

• With this technique, the operating time and post op complaints are subjectively less.

CONCLUSIONS

• Sutureless and glue free limbal conjuctival autografting following pterygium excision is a safe, effective and economical option for the management of primary pterygium.

• This simple technique for pterygium surgery may prevent potential adverse reactions encountered with the use of foreign materials.