Comparative Study Of Conjunctival Autograft Using Autologous Blood With Fibrin Glue In Treatment Of Pterygium

Abstract

BACKGROUND: Pterygium is a common ocular surface disorder. It is a hyperplastic and elastotic degeneration which proliferates as vascularized granulation tissue under the conjunctival epithelium and encroaches as wing shaped fold upon cornea. There are a wide variety of surgical methods to prevent its recurrence and each method has its own merits and demerits. Amongst all the surgical options available, conjunctival autograft is the most frequently practiced method. With the availability of newer techniques, the cost effectiveness and success rates of the surgery have improved with minimal complications. Conjunctival autograft trials have included graft with fibrin glue /sutures which can be compared with the equally successful but cost effective method of suture less and glue free conjunctival autograft. If the latter method is found to have same result as the former method, then not only it will help to prevent recurrence but also prove to be cost effective, for the patients especially in developing countries. AIM AND OBJECTIVE OF THE STUDY: To compare the effectiveness, outcome and complications with use of Autologous blood and Fibrin Glue in attaching the conjunctival autograft after pterygium excision. MATERIALS AND METHODS: It is a prospective randomized controlled hospital based study of patients who will be operated for pterygium in which 50% patients will undergo pterygium excision with attachment of conjunctival autograft using autologous blood and 50% XI patients will undergo pterygium excision with attachment of conjunctival autograft using fibrin glue. All patients will be inpatients of Department of Ophthalmology at B.L.D.E.U’s Shri.B.M.Patil Medical College Hospital and Research Centre, Vijayapur. Duration of this study was from October 2013 to March 2015. RESULTS: A total of 50 eyes were included in the study. Each group had 25 eyes. All cases of primary progressive pterygium were included in the study. Mean age in Group I was 44.60 years and 44.64 years in Group II. In this study we observed that 24% belonged to grade I, 56% to grade II and 20% to grade III pterygium. Maximum incidence of pterygium was seen in the age group of 31– 50 years. Majority of them were females (56%). Incidence of pterygium was higher in outdoor workers (60%). At the first week follow up, graft oedema, subconjunctival haemorrhage and retraction were seen in 4%, 0% and 4% respectively in patients of group I. In group II, graft oedema, subconjunctival haemorrhage and retraction were seen in 16%, 36% and 12% respectively. These findings in both groups, eventually resolved. At Subsequent follow ups, no recurrence was seen in either of the study groups. CONCLUSION: Sutureless glue free limbal conjunctival autografting following pterygium excision may prevent potential adverse reactions encountered by foreign materials like suture and fibrin glue, equally effective in preventing recurrence, safe and economical alternative for autograft fixation in pterygium surgery for developing countries.