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

Abstract

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.