Pterygium excision and conjunctival autograft: A comparative study of techniques

BACKGROUND: Use of conjunctival autograft following excision has reduced the recurrence rate of primary pterygium. This study compares the use of fibrin glue, autologous blood, and sutures in placing the conjunctival autograft in reference to surgical time taken, postoperative discomfort, and recurrence during follow-up. MATERIALS AND METHODS: Sixty patients with primary pterygium were included in the study and divided into three groups. In Group I, autograft was attached in place with help of 10-0 polyamide monofilament suture; in Group II, with autologous blood; and in Group III, with fibrin glue. All three groups were compared in terms of surgical time, postoperative discomfort, and recurrence. RESULTS: The average surgical time taken was least with fibrin glue group (Group III), i.e., 36.2 min, followed by 44.8 min with autologous blood group (Group II) and maximum of 53.3 min with suture group (Group I). Postoperative discomfort was seen maximum in th suture group (Group I) and was minimal in the fibrin glue group (Group III). At the end of final follow-up at 6 months, one case of recurrence was seen in both Group I and Group II. No recurrence was seen in Group III. CONCLUSION: The study concluded that fibrin glue remains the most effective method for attaching conjunctival autograft in pterygium surgery with least surgical time and postoperative discomfort. Autologous blood is an effective alternative which is easily available, economical, vis a vis fibrin glue with less surgical time and postoperative discomfort. Use of sutures is an older technique with maximum surgical time and postoperative discomfort. Recurrence is least with fibrin glue.