DOI: 10.21276/aimdr.2018.4.4.OT1
Original Article ISSN (O):2395-2822; ISSN (P):2395-2814
Annals of International Medical and Dental Research, Vol (4), Issue (4) Page 1
Section: Ophthalmology
Study Of The Surgical Outcome Of Sutureless Glueless
Conjunctival Autograft In Pterygium Excision Surgery.
Roopam Chauhan
1
, Jaya Devendra
2
, P.S. Rastogi
3
, Ashish Chander
4
, Gopesh Mehrotra
5
1
Junior Resident, Department of Ophthalmology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
2
Professor and Head, Department of Ophthalmology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
3
Assistant Professor, Department of Ophthalmology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
4
Associate Professor, Department of Ophthalmology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
5
Assistant Professor, Department of Ophthalmology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
Received: May 2018
Accepted: June 2018
Copyright: © the author(s), publisher. Annals of International Medical and Dental Research (AIMDR) is an
Official Publication of “Society for Health Care & Research Development”. It is an open-access article distributed
under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-
commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Pterygium is a hyperplastic elastoid wing shaped degenerative condition of the subconjunctival tissue which
proliferates as vascularized granulation tissue infiltrating the cornea destroying the superficial layers of stroma and
Bowman’s membrane causing corneal distortion and significant amount of astigmatism. Conjunctival autograft is a
relatively new and effective surgical technique with good aesthetic results in the management of primary pterygium.
Objective: To evaluate the surgical outcome in terms of recurrence and other complications of sutureless glueless
conjunctival autograft in pterygium excision. Setting: Department of Ophthalmology, Teerthanker Mahaveer Medical
College and Research Centre, Moradabad, Uttar Pradesh. Methods: Prospective interventional non randomized hospital
based case series was carried out in 50 eyes with primary pterygium. Pterygium excision with limbal conjunctival autograft
without glue or suture was performed in all patients. The patients were followed post operatively on day 1, day 7, 1 month
and 6 months. Recurrence and other complications were noted at each visit. Results: Mean age of the study population
was 36.96 11.39 years, 64% were males with maximum patients (72%) presenting in the age group of 20-40 years. The
overall complication rate was 10%. Graft retraction was seen in 4%, Conjunctival Cyst in 2% and 1 case showed Graft
Rejection. Recurrence rate was noted to be 2% at the end of 6 months. Conclusion: Sutureless glueless conjunctival
autograft following pterygium excision is a simple, safe and economical procedure for the treatment of pterygium having
excellent outcome.
Keywords: Pterygium, sutureless, glueless conjunctival autograft, recurrence.
INTRODUCTION
The term ‘pterygium’ has its origin from the ancient
Greek word (pteryx) = wing and (gion) = fin.
Therefore, pterygium is described as a triangular
‘wing-like’ growth consisting of conjunctival
epithelium and hypertrophied subconjunctival
connective tissue that occurs nasally or temporally in
the interpalpebral fissure, encroaching onto the
cornea.
[1]
The worldwide prevalence rates vary between 0.3-
2.9%,
[2,3]
higher in the ‘Pterygium Belt’ having
geographical latitudes of 40° north and south of the
equator,
[1]
the peri-equatorial region which includes
India.
The UV Type B light in solar radiation has been
implicated as a major environmental risk factor in
Name & Address of Corresponding Author
Dr. Ashish Chander
Associate Professor,
Department of Ophthalmology,
Teerthanker Mahaveer Medical College and Research
Centre, Moradabad,
Uttar Pradesh, India.
the pathogenesis of pterygium.
[2,3]
Hence, men with
outdoor work are affected more commonly than
women.
[4]
Pterygium is a hyperplastic, elastoid wing shaped
degenerative condition of the sub-conjunctival tissue
which proliferates as vascularized granulation tissue
to infiltrate the cornea destroying the superficial
layers of stroma and bowman’s membrane.
[5,6]
Molecular genetic alterations like loss of
heterozygosity, point mutations of proto-oncogenes
such as k-ras and alterations in the expression of
tumour suppressor genes such as p53 or p63 have
pointed towards pterygium being a proliferative
rather than a degenerative condition.
[7]
The tractional force of contractile elements within
the pterygium lead to mechanical distortion and
flattening of the cornea in its horizontal meridian
resulting in hypermetropic with the rule
astigmatism.
[8,9]
The indications for pterygium surgery are:
(a) Visual Impairment
(b) Recurrent Inflammation
(c) Motility Restriction
(d) Cosmetic Disfigurement.