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Faster and cost-effective ways for conjunctival autograft (CAG) fixation in pterygium surgery and their comparative results

Session Details

Session Title: Cornea Medical

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 09:54

Venue: Elicium 1 (First Floor)

First Author: : T.Chowdhury INDIA

Co Author(s): :                  

Abstract Details

Purpose:

Last year ESCRS, we presented CAG fixation in pterygium surgery: no suture, no glue, autoblood is enough. Now I do pterygium surgery in autoblood method as well as fix the CAG by electrocoaptation method. The purpose of the study is to 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.

Setting:

Disha Eye hospitals, Kolkata, India.

Methods:

Prospective, comparative, interventional case study for 112 cases of primary nasal pterygium surgery where 69 cases underwent STCAG and 43 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 donor edge at 5 points.In both groups the eye was patched, which was removed next day morning.

Results:

I compare the outcomes of both procedure 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 goups. In 2 patients with STCAG the graft was puckered which needed suturing of the graft. No graft was puckered in EFCAG. No graft was recessed in STCAG and 2 graft was recessed in EFCAG from the donor edge medially.Follow-up ranged from 4 to 21 months in STCAG and 3 to 14 months in EFCAG. Minor complications like subgraft hemorrhage was found in 11 cases of STCAG but none in EFCAG. The subgraft hemorrhage was resolved over a mean period of 18 days. 3 cases had recurrence in STCAG group but none in EFCAG group. No patient had any discomfort as in suture related grafts in any time during follow-up visits.

Conclusions:

Conjunctival auto graft fixation in pterygium surgery by both the methods are faster than suture fixation and cost effective as it avoids the cost of fibrin glue.Both the 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.

Financial Interest:

NONE