Online ISSN: 2515-8260

Keywords : Autologous blood


Conjunctival auto-graft after pterygium surgery: leave it or stitch it : Surgeon‟s Dilemma.

Dr. Ashka Patel; Dr Aneri Shah; Dr. Vaishali Prajapati; Dr. Hasti Lo; Dr. FarheenLaliwala; Dr. Deepika Singhal; Dr. Abhay Gaidhane

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 2681-2686

INTRODUCTION-Pterygium is a degenerative condition of subconjunctival tissue which proliferates as vascularized granulation tissue to invade the cornea, destroying the superficial layers of stroma and Bowman’s membrane. As a result of tissue fibrosis it leads to alteration of corneal curvature resulting in astigmatism and corneal opacity. The pathophysiology includes Ultraviolet rays (UVR) induced elastoid degeneration of subepithelial connective tissue, genetic trauma and consequent altered cytokine expression.Management includes, novel method of adhering graft to recipient site by patient’s own blood to reduces complications associated with it and other surgical technique like use of sutures and fibrin glue.
AIM - To study postoperative outcomes of pterygium excision surgery with autograft using autologous blood versus conventional sutures.
METHODS-Present study includes aserial follow up of Forty patients with primary nasal pterygium, who underwent pterygium excision surgery with conjunctival autograft. The patients were randomly divided into two groups for pterygium excision with autograft using either Group-A autologous blood (20 patients) and Group-B underwent sutures (20 patients).Post-surgery patients were examined on day1, day 7 and day 30 to document the graft loss. Graft stability was also assessed on day 1 in both groups. Groups were finally compared for: graft edema, graft stability, recurrence and suture related complications like foreign body sensation, watering, discomfort, granuloma formation and suture abscess.
RESULTS-Better graft stability was documented in all the cases from Gp-B (ie. suture group) whereas in Gp-A, displacement of graftwas documentedin six cases and hence re-suturing was done. Graft edema was documented amongst 10 cases in Group Aand 7 cases 
in Group B. At the end of 30 days, all patients of both the groupspresented with similar observations. However, during each of the proposed follow up, subjective discomfort was more in group B as compared to group A.
CONCLUSION-Although, Suture related complications were more prominent in the group B, but graft displacement was a challenge with autologous blood groupie group A patients. As the present study cites low incidence of complications in both groups , the Surgeons dilemma persists to decide if auto graft in pterygium needs to be left or stitched.