Comparison of Sutureless, Glue-Less Conjunctival Autograft Versus Sutured Limbal Conjunctival Autograft for Primary Pterygium

Abstract

Objectives: The objective of the study was to compare and evaluate efficacy of two surgical techniques for the management of primary pterygium in terms of complications and post-operative signs and symptoms. Methods: The study included 60 patients with primary pterygium. The mean age was 42±10 years (range 22–62 years). Simple excision under local anesthesia was performed followed by closure of the bare sclera by suture less and glue free conjunctival autograft in 30 patients (Group I), versus the conventional method of a sutured conjunctival autograft in 30 patients (Group II). Results: At Visit 1, 6 patients (20%) of Group I had Graft edema in comparison to 5 patients (16.67%) in Group II. Subcutaneous hemorrhage was noted in 6 (20%) patients in both the groups. Graft retraction was noticed in 4 patients (13.33%) in Group I and in 2 patients (6.66%) in Group II. Graft dislodgement was observed in 1 patient (3.33%) in Group I. One (3.33%) case of recurrence was reported at 6 months in Group I whereas 2 (6.67%) cases were reported in Group II. One case of Granuloma was reported in Group II. There were significantly lower post-operative signs and symptoms in Group I as compared to Group II in the 1st post-operative week and the difference between the two groups was statistically significant (p<0.05) at visit 1 and visit 2. The satisfaction survey revealed higher overall satisfaction score for Group I as compared to Group II. Conclusion: Sutureless technique may be considered as a viable alternative to sutured technique in terms of surgical outcomes. It scores better in terms of post-operative symptoms when compared to sutures.

Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis

“…All the included studies showed a low risk of performance bias apart from Elwan 16. Four articles showed a low risk of detection bias,13 16 22 23 and all the included articles showed a low risk of attribution bias. All the included articles showed a low risk of reporting bias, and eight articles showed unclear risk of other sources of bias (figure 2).…”

“…After evaluating titles and abstracts, 22 articles were excluded, resulting in 13 articles that underwent full-text assessment. Ultimately, 11 RCTs met the eligibility criteria 13–23…”

“…The meta-analysis included 11 articles, including 833 patients with primary pterygium 13–23. Of them, 394 and 439 patients were treated with sutureless and sutured techniques, respectively.…”

“…All the included articles showed a low risk of reporting bias, and eight articles showed unclear risk of other sources of bias (figure 2). 13 15 16 18 19 21–23…”

“…These studies have shown that the modified graft fixation technique, which eliminates the need for sutures and the employment of adhesive agents, holds promise as a viable and efficient approach for primary pterygium surgeries. Furthermore, it offers certain advantages over the traditional suturing method, such as reduced surgical duration, enhanced graft stability and diminished postoperative discomfort 13–23. Hence, a meta-analysis is warranted to delineate a definitive conclusion.…”