Comparison of three different techniques for fixation of conjunctival autograft in pterygium surgery

The aim of our study was to evaluate and compare three different surgical options for treatment of pterygium with conjunctival autograft (CAG) using sutures, tissue glue, and autologous in situ blood coagulum.

A prospective randomised clinical study was carried out in 60 patients with progressive nasal pterygium. Patients were randomly grouped into three groups, Group I CAG with 8–0 vicryl sutures (n=20), Group II CAG with tissue glue (n=20), Group III CAG with autologous in situ blood coagulum (n=20). All patients were followed up on day one post-operative, 1 week, 1 month and 6 months post operatively. The surgical time, post-operative discomfort, graft stability, recurrence rate and complications were compared.

The average surgical time was statistically more in Group I (p<0.05) being 44.2 ± 2.12 minutes, compared to 22.25 ± 0.97 minuntes in Group II and 24.85 ± 1.76 minutes in group III. Post-operative discomfort being maximum in Group I in the early post-operative period which was statistically significant (P<0.05) compared to Group II and Group III. Graft retraction rate was maximum in Group III (15%) compared to Group II (10%) and Group I and (5%). No graft losses were reported. Recurrence rate of (15%) was seen in Group I, (10%) in Group II, (5%) in Group III at the end of 6 months, not statistically significant.

All three techniques are safe and effective in treating primary pterygiums. But tissue glue and autologous in situ blood coagulum techniques significantly reduce post-operative discomfort and surgical time.