A Comparative Study of Postoperative Outcome After Pterygium Excision Using Autologous Blood and Sutures

Singh, Harpal; Laad, Sagarika; Pattebahadur, Rajesh Sripat; Saluja, Pranav; Ramnani, Parag

doi:10.18410/jebmh/2017/1213

Cited by 5 publications

(7 citation statements)

References 18 publications

(18 reference statements)

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“…The rate of granuloma formation was higher in suture group (9.1%). Recurrence rate was 22.7% in suture group compared to 3.6% in autologous blood group [20]. These results are comparable to our study.…”

Section: Discussionsupporting

confidence: 89%

Comparison of Conjunctival Autograft Technique Using Autologous Blood as Glue Versus Suture Technique in Pterygium Surgery

Singh

Sonwani

Shrivastava

2020

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Aim: To compare the post-operative inflammation, surgical time and complications in conjunctival autografting with oozed autologous blood versus sutures in primary pterygium surgery. Study Design: Prospective interventional study. Place and Duration of Study: Department of Ophthalmology, CIMS, Bilaspur (C.G), India. (Jan 2017-May 2018). Methodology: 80 eyes of 80 patients (25 to 75 years) presented with primary pterygium up to grade 3 were included in this prospective interventional study presented in eye OPD, CIMS, Bilaspur (CG). All the procedures and post-operative evaluation was done by the same surgeon. All the patients were divided into two groups on alternate basis. 40 patients received conjunctival autografting with oozed autologous blood (CAGb) and 40 patients received sutures (CAGs). These two groups were then compared for post-operative inflammation, surgical time and complications (day 1, day 5, 2 weeks, 1 month and 3 month). Result: Total 80 patients were evaluated after surgery. Progressive pterygium was observed in more than 50% cases in both groups. Post-operative inflammation and discomfort was significantly lower in CAGb group compared to CAGs group (P<.001). Mean surgical time was also significantly less in CAGb group (11.6±2 min) compared to CAGs group (21.6±3min) (P<.001). In CAGb group 5% patients had graft displacement while none in CAGs group. Granuloma formation was higher in CAGs group (12.5%) compared to CAGb group (7.5%). Subgraft haemorrhage was 10% in CAGb and 17.5% in CAGs group. Dellen formation was seen in 3 patients in CAGb and 4 patients in CAGs. Recurrence rate was higher in suture group (5/40 in CAGs vs 1/40 in CAGb). Conclusion: Our study concludes that placement of conjunctival autograft with oozed autologous blood as adhesive after pterygium excision is an effective, less inflammatory and less time consuming approach, with significantly lower rates of post-operative complications. This can be used as a better alternative to suture technique.

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Section: Discussionsupporting

confidence: 89%

Comparison of Conjunctival Autograft Technique Using Autologous Blood as Glue Versus Suture Technique in Pterygium Surgery

Singh

Sonwani

Shrivastava

2020

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“…Six patients (6.97%) of Group 2 however had graft dislodgment. This was consistent with the study of Singh et al 7 These patients were taken to the eye OR again and had their grafts repositioned. No adverse event was noticed in these patients henceforth.…”

Section: Discussionsupporting

confidence: 91%

“…5.81% of patients in Group 1 and 3.49% patients in Group 2 had recurrences which occurred between six-and nine-months following surgery. The slightly higher recurrence in patients undergoing sutures was also reported by other studies 7,8 and was attributed to tissue inflammation that occurred due to suturing. 9,10 The period of recurrence compared favourably with separate studies done by Ti et al and Hirst et al who mentioned that 93% recurrences occur by the end of nine months following initial surgery.…”

Section: Discussionsupporting

confidence: 81%

“…9,10 The period of recurrence compared favourably with separate studies done by Ti et al and Hirst et al who mentioned that 93% recurrences occur by the end of nine months following initial surgery. 7,8,11,12 The strength of this study lied in the fact that two variations of the same technique were done in two eyes of the same patient, which probably eliminated other avenues of inter patient variability. Having fewer surgeons who are well adapted to the surgical technique reduced inter surgeon variability and perhaps explained the low incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Outcomes Following Sutured Autografts and Suture-Less, Glue-Less Autografts in Primary Pterygia: A Comparative Study

Chakraborty¹,

Agrawalla²

2019

jebmh

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BACKGROUND Conjunctival autografts have practically replaced bare sclera technique as the preferred modality of pterygium surgery. Three options are available for graft anchorage-sutures, autologous blood and artificial glue. The last option is less commonly practised than the former two due to issues related to price and availability. The aim of this study was to compare the surgical outcome of the two common techniques by which conjunctival autografts are done in primary pterygia. METHODS Eighty-six patients with bilateral and nearly symmetric progressive primary pterygia seen over a period of 3 years 6 months were included in this study. One eye of these patients underwent pterygium excision followed by conjunctival autograft where the graft was secured in place with interrupted non absorbable sutures (Group 1). The other eye of the same patient underwent the same procedure one month later, but no sutures or glue was used, and autologous blood was used as the adhesive. This group was called the glue less, suture less group or Group 2. Patients were followed up for a period of one year and were compared with regard to time taken for surgery, recurrence and post-surgical complications. RESULTS Average surgical time was 23.7 minutes in Group 1 and 12.4 minutes in Group 2. Graft displacement was seen in 6 cases (6.97%) in Group 2 which had to be subsequently repositioned in the OR. No such incident was noted in Group 1. Two patients of Group 2 (2.32%) had sub graft haemorrhage which had to be cauterised. Incidence of recurrence was 5 out of 86 patients (5.81%) in Group 1 and 3 out of 86 patients (3.49%) in Group 2. CONCLUSIONS Glue-less suture-less surgery offered a fast and acceptable alternative to traditional sutured grafts. Sutured grafts had a less eventful post-surgical course but in terms of recurrence both offered equivalent results.

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“…The prevalence of pterygium varies widely with age, sex, and socioeconomic background. [2] Ultraviolet (UV) rays are the most well-known risk factor. Both the intensity and duration of UV radiation exposure are associated with morbidity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Autologous Blood Coagulum (ABC) and Suture at Recurrence Rate and Graft Stability of Postoperative Primary Pterygium Using Conjunctival Autograft: A Meta-Analysis From Randomized Controlled Trial

Kartika

Dwipayana²,

Lutfi³

2022

VSEHJ

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Introduction: The main challenge of pterygium management is the postoperative recurrence rate. Currently, the use of surgical sutures for conjunctival autograft fixation, which has prolonged surgery duration, has a risk of increased inflammation and infection. Recently, some reports about autologous blood coagulum (ABC) for conjunctival autograft fixation. This technique has a minimal cost and minimal risk of infection. Purpose: The study aimed to evaluate the postoperative recurrence rate and graft stability after using ABC and sutures. Methods: A systematic research was done on Pubmed, Cochrane Library, and Science Direct online databases for all relevant randomized controlled trials (RCTs) up to 18 July 2020. The collected RCTs were independently screened and identified to match the inclusion criteria. The relevant data were compiled in population, intervention, control, outcomes (PICOs) format and analyzed with Review Manager 5.3 software. Results: Nine RCTs involving a total of 764 patients were assessed. The primary outcome indicates that ABC significantly reduced the recurrence rate compared to sutures (RR = 0.51, 95% CI 0.27 to 0.98, p = 0.04). Meanwhile, in graft stability, the suture was statistically better than ABC (RR = 1.95, 95% CI 1.27 to 3.01, p = 0.002). As a secondary outcome, the duration of surgery was significantly shorter in ABC than in sutures (MD -15.22, 95% CI -22.57 to -7.88, p<0.0001). Conclusions: Although the graft is less stable, ABC may be a promising approach after pterygium excision. The use of autologous blood for conjunctival autograft fixation in primary pterygium was associated with a lower recurrence rate and shorter duration of surgery.

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A Comparative Study of Postoperative Outcome After Pterygium Excision Using Autologous Blood and Sutures

Cited by 5 publications

References 18 publications

Comparison of Conjunctival Autograft Technique Using Autologous Blood as Glue Versus Suture Technique in Pterygium Surgery

Comparison of Conjunctival Autograft Technique Using Autologous Blood as Glue Versus Suture Technique in Pterygium Surgery

Surgical Outcomes Following Sutured Autografts and Suture-Less, Glue-Less Autografts in Primary Pterygia: A Comparative Study

Comparison of Autologous Blood Coagulum (ABC) and Suture at Recurrence Rate and Graft Stability of Postoperative Primary Pterygium Using Conjunctival Autograft: A Meta-Analysis From Randomized Controlled Trial

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