Faster and Cost-Effective Ways for Conjunctival Autograft Fixation in Pterygium Surgery and Their Comparative Results
Narrative Responses:
Purpose
Now I do pterygium surgery by sutureless and gluefree autoblood method as well as fix the CAG by electrocoaptation method. I assess the role of sutureless and gluefree subconjuntival tuck-in CAG (STCAG) where autoblood act as glue and electrocoaptation fixated CAG (EFCAG) in pterygium surgery and compare their outcomes.
Methods
Prospective, comparative, interventional case study for 124 cases of primary nasal pterygium surgery where 69 cases underwent STCAG and 55 cases underwent EFCAG. The graft was taken from superior bulbar conjunctiva. in both groups patient's own blood clot oozed after pterygium excision act as tissue adhesive and the graft fixation was further strengthened by either subconjunctival tuck-in procedure or by electrocoaptation of the graft and recipient edge at 5 points. In both groups the eye was patched, which was removed next day morning.
Results
I compare the outcomes of both procedures in relation to surgical time, post-operative patient discomfort and complication along with cosmetic results. Mean surgical time in STCAG group was 10.6 minutes and that in EFCAG group 8.3 minutes. No graft was dislodged in immediate post-operative period in both groups. . No graft was recessed in STCAG and 2 graft was recessed in EFCAG from the recipient edge medially. Follow-up ranged from 4 to 21 months in STCAG and 3 to 14 months in EFCAG. 3 cases had recurrence in STCAG group but none in EFCAG group.
Conclusion
Conjunctival auto graft fixation in pterygium surgery by both methods are faster than suture fixation and cost effective as it avoids cost of fibrin glue. Both procedures are having good and faster rehabilitation without any cosmetic blemish and avoids post-operative suture related problems and gives all the benefits of synthetic glue.