BACKGROUNDEndothelial cell loss during cataract surgery leads to corneal decompensation and visual loss.

BACKGROUNDThe purpose of this study is to assess the efficacy and safety of "No glue, no stitch technique of conjunctival autograft after pterygium excision" and also to study the recurrence rate for limbal conjunctival autograft after pterygium excision without sutures or fibrin glue. MATERIALS AND METHODSThe present study titled, "No glue, no stitch technique of conjunctival autograft in pterygium surgery" was a prospective interventional case series study conducted at Sarojini Devi Eye Hospital, Hyderabad, from December 2011 to May 2013. The study included fifty eyes of fifty consecutive patients who presented with primary pterygium to our outpatient department. RESULTS"No glue and no stitch technique of limbal conjunctival autografting" following pterygium excision is a safe, effective and economical option for the management of primary pterygium requiring surgical intervention. However, there is a risk of graft retraction, graft dislocation and recurrence in small percentage of cases. A prospective randomised controlled trial is required to investigate the long-term efficacy of this grafting technique in reducing recurrences. KEYWORDSPterygium, Autograft, Glue, Fibrin, Limbal Cells, Mitomycin C. HOW TO CITE THIS ARTICLE:Satyavani P, Padmavathi V, Mahendra S, et al. No glue, no stitch technique of conjunctival autograft in pterygium surgery.

Patients of Fungal Keratitis not responding to routine topical and systemic antifungal therapy in 7 to 14 days, which were diagnosed as Recalcitrant fungal keratitis were given 5µgms/0.1ml of voriconazole intrastroml injections around the fungal infiltrates in a grid pattern. Details of patients age and sex, type of causative fungal and traumatic agents, size of corneal ulcer, presence of Hypopyon or not, and time taken for hypopyon absorption, and clinical improvement and resolution of the ulcer and visual acuity were noted. RESULTS: This study group of 30 patients diagnosed as Recalcitrant fungal keratitis showed Causative Fungi as Fusarium in 19(63.0%), Aspergillus in 11(37.0%). Causative Traumatic Agents were vegetative matter in 19 (63.3%), other agents in 8(26.7%) and not known in 3(10.0). 17(56.7%) were Males with 13(43.3%) Females. Age wise distribution was 3(10.0%) in>10-20yrs, 11(36.7%) in 20-40 yrs, 15(50.0%) in 40-60 yrs, and 1(3.3%) in >60 yrs. The size of the ulcer showed <1/2 of the cornea in 21(70.0%) and >1/2 of the cornea in 9(30.0%). 19 (63.3%) were with hypopyon and 11(36.7%) without hypopyon. After Intrastromal Voriconazole, the absorption of Hypopyon in 12 (63.2%) was in 2to 4 wks. and in 2(10.5%) in > 4 wks. Clinical improvement of the Fungal Corneal Ulcer was seen in no case (0.0%) in <1 st wk., in 24(80.0%) in 2 to 4wks and in 2(6.7%) in > 4 wks. Time (wks.) of healing of the Fungal Corneal Ulcer was in 4-6wks in 21 (70.0%) and in >6wks in 5(16.7%). Visual Acuity was <3/60 in 2(7.7%), 3/60-<6/60 in 10(33.3%), 6/60-<6/18 in 9(30.0%) and 6/18-6/9 in 5(16.7%). CONCLUSION: Common causes of fungal keratitis in Recalcitrant Fungal keratitis were Fusarium in 15(50.0%), Aspergillus in 12(40.0%) and Candida in 3(10.0). Intrastromal Voriconazole has a therapeutic role in resolving recalcitrant fungal keratitis not responding to routine antifungal therapy within 4-6 wks.