PTERYGIUM EXCISION WITH SUTURELESS GLUELESS CONJUNCTIVAL AUTOGRAFTING: AN EXPERIENCE OF 30 CASES (original) (raw)
Related papers
Outcome of Pterygium Excision and Conjunctival Autograft: without suture, without Glue
Z H Sikder Women’s Medical College Journal
Purpose: To determine the outcome of suture less and glue free conjunctival autograft for the management of primary pterygium. Materials and Methods: This prospective nonrandomized, noncontrolled interventional study was carried out in a tertiary eye care hospital, Bangladesh from July 2018 to December 2019. We included all patients with primary nasal pterygium who were selected for surgical excision with limbal conjunctival auto grafting without using fibrin glue or sutures. The patients were followed-up post-operatively on 1 st day, 1 week, 1 month, and 3 monthly up to one year. They were examined for sub-conjunctival hemorrhage, graft displacement, chemosis, graft dehiscence, graft retraction, recurrence, or any other compilation. Appropriate statistical method was used to analyze the data. Result: Fifty eyes of fifty patients were evaluated in this study. 13 cases were female, and 37 cases were male. The mean age was 38.23 years with age range from 20 years to 50 years. The recurrence rate was 8% (4 eyes out of 50). All cases of recurrence occurred after 6 months. Graft dehiscence occurred in 4% (2 eyes out of 50). Graft dislocation was found in 8 % (4 eyes out of 50 eyes) and the graft was not found in recipient scleral bed at 1 st week. Graft retraction with exposure of scleral bed occurred in 10% cases (5 eyes out of 50) within the first post-operative week due to conjunctival oedema and chemosis. Conjunctival graft oedema occurred in 20 cases (40%), that was resolved gradually within a week. Conjunctival sub-graft hemorrhage occurred in two cases (4%) at 1st post-operative day, and it was gradually resolved within 3 weeks and was no effect on graft fixation. Conclusion: Suture less and glue free conjunctival auto grafting following pterygium excision is a safe, effective, and economical option for the management of primary pterygium. This procedure is free of any untoward complication.
Efficacy of glue free and sutureless limbal conjunctival autograft for primary pterygium surgery
Background: There are numerous adjunctive measures described to reduce the recurrence rates after pterygium excision. Sutureless glueless conjunctival autografting in pterygium surgery is gaining popularity due to short surgical time, no recurrence and good cosmetic outcome. The main objective to study the efficacy and complications of sutureless and glue free limbal conjunctival autograft for the management of primary pterygium. Materials and methods: A prospective interventional case series was carried out in 50 consecutive eyes with primary nasal pterygium requiring surgical excision. Pterygium excision with limbal conjunctival autografting without using glue or sutures was performed in all the patients followed by bandaging for 48 hours. The patients were followed up post operatively on 2nd day, 1 week, 6 weeks, 6 months and 12 months. They were examined for haemorrhage, wound gape, graft shrinkage, chemosis, graft dehiscence, recurrence or any other complication. Results: The mean age of the patients was 41.14 years (range 25-60), 66% were males. Total graft dehiscence occurred in 2 eyes (4%), graft retraction in 2 eyes (4%). No recurrene and no other complication was noted. Conclusions: Sutureless and glue free limbal conjunctival autografting following pterygium excision is a safe, effective and economical option for the management of primary pterygium.
Pterygium excision with suture-less and glue-free conjunctival autograft
Asian Journal of Ophthalmology, 2020
Introduction: Pterygium excision is a commonly encountered surgery with different methods being used. These procedures range from simple excision to use of grafts. Limbal conjunctival autograft is currently the most popular surgical procedure. The most common method of autograft fixation is suturing. But it has its own drawbacks like increased operating time, post-operative discomfort, inflammation, buttonholes, necrosis, giant papillary conjunctivitis, scarring, and granuloma formation. Glue is widely used due to many advantages like easy fixation of the graft, shorter operation time, and reduction in complications and post-operative discomfort but at the same time has some disadvantages also like high cost, the risk of transmission of infectionsand inactivation by iodine preparations. Purpose: In the following study, we describe a simple method of accomplishing conjunctival autograft adherence during pterygium surgery avoiding possible complications associated with the use of fibr...
Annals of International medical and Dental Research, 2018
Background: Pterygium is a hyperplastic elastoid wing shaped degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue infiltrating the cornea destroying the superficial layers of stroma and Bowman's membrane causing corneal distortion and significant amount of astigmatism. Conjunctival autograft is a relatively new and effective surgical technique with good aesthetic results in the management of primary pterygium. Objective: To evaluate the surgical outcome in terms of recurrence and other complications of sutureless glueless conjunctival autograft in pterygium excision.
Sutureless and glue free conjunctival autograft in pterygium surgery
Acta Ophthalmologica, 2009
Foreign materials used in ocular surface surgery may lead to local complications such as discomfort, scarring, or infection. Plasma-derived products such as fibrin glue may produce possible hypersensitivity reactions whereas the risk of viral transmission remains. We describe a simple method of achieving conjunctival autograft adherence during pterygium surgery avoiding potential complications associated with the use of fibrin glue or sutures. Pterygium excision with limbal conjunctival autografting without using glue or sutures was performed in all the patients followed by bandaging for 24 hours. The patients were followed up post operatively on 2nd day, 1 week, 1 month, 3 month and 6 months. They were examined for haemorrhage, wound gape, graft shrinkage, chemosis, graft dehiscence, recurrence or any other complications. Total 100 cases were included in this case series. Patient age in ranged from 23 to 78 years (mean 50. 08 ± 12.76 years). Surgical Time was (in Minutes) from 20-28; mean & SD 23.76 ± 1.89. Total graft dehiscence occurred in 1 eye (1%), graft retraction in 12 eyes (12%) and recurrence was seen in 1 eye (1%). At 3 month postoperatively, the gain in uncorrected visual acuity ranged from 2-3 line in Snellen chart in 13 eyes. No other complication was noted. This simple technique for pterygium surgery may prevent potential adverse reactions encountered with the use of foreign materials and in this case series provided safe and comparable results to current methods.
IP innovative publication pvt. ltd, 2019
Introduction: A pterygium is a triangular 'wing-like' growth consisting of conjunctival epithelium and hypertrophied subconjunctival connective tissue that occurs nasally and/or temporally in the palpebral fissure and encroaching over to the limbus and then to the cornea. Actual pathogenic mechanisms of this condition is unknown hence remains an enigma in ophthalmlogy. This degenerative thick and vascular conjunctival and sub-conjunctival tissue is triangular in shape and most commonly found on the nasal side and also it progressively destroys the corneal bowman's layer and superficial layer of the stroma. It is most commonly seen in the tropical country, implicating sunlight and UV radiation as a probable cause. Objective: To compare the post-operative outcome of primary pterygium excision followed by autologous limbal conjunctival grafting with application of sutures vs suture-less and glue-less. Materials and Methods: This study is a prospective comparative and interventional case study. 50 eyes with primary pterygium are selected. Patients were divided into two equal groups with 25 number of eyes in each group. a) Group-I = suturing of auto graft with (10-0) nylon sutures b) Group-II = fixing of auto graft without sutures i.e. Suture-less and without glue i.e. glue-less. Results: The average operative time for Group-I was 26.44 ± 8.19 min and for Group-II was 20.52 ± 5.13 min (p-value < 0.05). Postoperative symptoms were seen in Group-I in 18 eyes i.e.72% and in Group-II in 4 eyes i.e. 16% (p-value <0.05). The severity of symptoms i.e. postoperative discomfort was observed more in Group-I than Group-II from 1 st Postoperative day. The duration of which lasted in Group-I for < 3 weeks for and Group-II for < 1 week (p-value < 0.05). The patients belonging to Group-II were symptom free than the Group-I from the first postoperative day onwards. Post operatively in Group-1 Graft oedema was seen in 5 eyes i.e.20% and in Group-II= 3 eyes i.e.12% which resolved within ≤ 2week. In Group-I = 2 patients i.e. 8% had graft lost and 1-patient i.e. 4% had recurrence which is statistically insignificant. Conclusion: Lots of surgical procedures has been tried for the treatment of primary pterygium this technique of fixing the auto-graft without sutures i.e. suture-less and without glue i.e. glue-less is rather an evolving one getting preference by the modern surgeons worldwide as it is less time consuming, more convenient in the sense of avoiding complication of sutures and glues thereafter the related problems of the sutures and glues, moreover it's cost effectiveness is an advantage.
IP Innovative Publication Pvt. Ltd, 2017
Aim: A comparative study on pterygium excision and glue free limbal conjunctival autograft with and without suture. Materials and Methods: 50 patients of primary nasal pterygium attending ophthalmology OPD in Rotary Hospital, Sirsi, Karnataka were randomly selected. The study was conducted during the period from June 2015 to January 2016. All patients were divided randomly into two groups. Group 1 consisted of 25 patients who underwent suture less, glue free limbal conjunctival autograft and Group 2 consisted of 25 patients who underwent limbal conjunctival autograft with suturing. Clinical data of all patients which included age, sex, laterality of pterygium as well as a history of other diseases, were obtained by reviewing the medical records and direct patient interview. All patients were subjected to detail comprehensive ophthalmic examination which included visual acuity, refraction, slit lamp biomicroscopy, measurement of IOP, extra ocular movements and dilated funduscopy. Results: In this study 50 primary nasal pterygium who underwent Surgery were assessed. Of 50 patients, 35 were male and 15 were female patients. The age of patients ranged from 30 years to 65 years. In our study mean Surgical time in Group A (n=25) was 20+1.5 min. as compared to Group B (n=25) which was 30+2 min. Early post-operative signs and symptoms like pain, foreign body sensation, hyperemia and chemosis were significantly less in Group A as compared to Group B. There was no significant difference is complication rate seen among to group except for graft retraction which was seen in Group A. Both groups achieved good visual acuity after 4 weeks. Both groups had no recurrence of pterygium. Conclusion: Among the two techniques Suture less and glue free limbal conjunctival autograft is easy to perform and it is safe, effective and economical.
Indian Journal of Clinical and Experimental Ophthalmology
To compare the efficacy and safety of sutureless glue-free versus suture technique for autogenous conjunctivolimbal grafting in primary pterygium excision. A prospective observational study was conducted in thirty consecutive patients of primary progressive pterygium after taking their informed written consent and ethical clearance in a tertiary eye care centre of Northern India. Patients were randomly divided equally into group “A” and “B” each constituting fifteen patients. Group A patients underwent suture technique and group “B” patients underwent sutureless technique for conjunctivolimbal graft placement. Comparison of both groups was done in terms of intraoperative time, postoperative symptoms and recurrence over a period of one year. Data was compiled and entered into Microsoft Excel software and SPSS version 21.0 was used for data analysis.The mean duration of surgery was 42 min and 30 min in group A and B respectively and this difference was found to be statistically signif...
Journal of evolution of medical and dental sciences, 2014
Evaluation of the benefits of suture less and glue free conjunctivo-limbal autograft for primary pterygium management. MATERIALS AND METHODS: This was clinical outcome study of 50 consecutive eyes with primary nasal pterygium requiring surgical excision. Autologous conjunctival graft taken at the superotemporal limbus was used to cover the sclera after pterygium excision. Sutureless and glue free conjunctivo-limbal autograft was performed in all the patients followed by bandaging for 24 hours. The patients were followed up post operatively on 2nd day, 1 week, 4weeks, 3 months, 6 months and 12 months. They were examined for subconjunctival hemorrhage, granuloma formation, graft dehiscence, graft rejection, graft retraction, chemosis, recurrence or any other complication. RESULTS: The study included 28 females and 17 males (mean age 39.3 years). Recurrence was seen in one eye (2.2%) of a patient at one year. Graft retraction on conjunctival side occurred in 5 eyes (11.1%). Partial Inferior flaps dehiscence in 2 patients (4.4%) and one conjunctival granuloma (2.2%) were noticed during 1 st week follow up. No any major postoperative complications occurred. CONCLUSION: The described technique is fast, safe, and effective and as well as economical while giving results without any increased chances of complications for the management of primary pterygium.
Cut & Place: A New Technique for Pterygium Surgery with Conjunctival Autograft
https://www.ijhsr.org/IJHSR\_Vol.6\_Issue.1\_Jan2016/18.pdf, 2016
Background: Sutureless glueless conjunctival autografting in pterygium surgery is gaining popularity due to short surgical time, no recurrence and good cosmetic outcome. Aims: To study the efficacy, safety and reliability, post operative recovery, complications and recurrence rate of pterygium with glueless and sutureless conjunctivo-limbal autograft for the management of primary pterygium. Materials and Methods: This was prospective, non comparative, interventional case series of 40 consecutive eyes with primary nasal pterygium requiring surgical excision. After pterygium excision, conjunctival autograft was taken from the superotemporal limbus and the bare sclera was covered with glueless and sutureless conjunctival autograft. Patching was done for 24hours and followed up post operatively on day 1, one week, one month, 3 months and 6 months. They were examined for graft dehiscence, graft recession, graft retraction, chemosis, recurrence or any other complications on each follow-up. Results: The study included 19 males and 21 females. All grafts were intact in first follow up. 22.5% had medial edge graft recession on 1 week follow up. 5% had graft retraction on 1 month follow up, 2.5% had graft edema on 1 week follow-up and there was no graft dehiscence. No recurrence of pterygium was found till 6 month follow up. Conclusion: Glueless and sutureless conjunctival autograft is a good option for pterygium surgery. It takes short surgical time and easy to perform, less patient discomfort, excellent cosmetic outcome and no recurrence.