Recurrence-free pterygium surgery with special surgical technique

• Published in: Medical Journal of Dr. D.Y. Patil Vidyapeeth Vol. 11; no. 6; pp. 492 - 498
• Main Author: Das, Sujit
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018
• Subjects: Pterygium; pterygium surgery; suture-free glue-free limbal conjunctival autograft
• ISSN: 2589-8302; 2278-7119
• DOI: 10.4103/mjdrdypu.mjdrdypu_49_18

Aim: The aim of this study was to evaluate and analyze the surgical outcome of suture-free, glue-free limbal conjunctival autograft after pterygium excision. Design: This was a prospective, interventional, and hospital-based study. Materials and Methods: Forty eyes of 40 patients with primary pterygium were graded, and excision was performed by the single surgeon. To prevent recurrence-free LCAG was used with special surgical technique “subconjunctival resection of fibrovascular pteygium and cauterization of limbal base to destroy abnormal limbal cells along with resection of 7-mm pteygium.” In this technique, we used patient's own blood as a bioadhesive. The eye was patched for 24 h postoperatively. Patients were treated with topical eye drop prednisolone acetate (1%) 1 drop six times per day with gradual tapering every week, eye drop moxifloxacin (0.5%) 1 drop four times per day, eye drop nepafanac (0.5%) 1 drop four times per day, eye drop carboxymethyl cellulose 1 drop six times per day, and carboxymethyl gel at night for 6 weeks. The outcomes were assessed regarding any recurrence, complication(s), and operative time at each follow-up visit on day 1, day 7, day 30, 3 months, 6 months, and 1 year. Results: There were 30 males (75%) and 10 females (25%). The mean age of all the patients was −51.15 (51.15 ± 10.3 years), range 51–60 years. Cosmetic reason was the chief indication of surgery (11 eyes, 27.5%), followed by recurrent redness (nine eyes, 22.5%). There was no recurrence, and the most common complication was hemorrhagic graft (18 eyes, 45%). All grafts appear indistinguishable by 3 months and were free of symptoms. Average surgical time was 18 ± 2 min. Conclusion: (1) 8-mm LCAG with subconjunctival resection of fibrovascular pteygium and cauterization of limbal base to destroy abnormal limbal cells are very affecting in preventing recurrences. (2) Using patient's own blood as bioadhesive is associated with less postoperative discomfort, less postoperative time, and less complications.