Comparative Analysis of Two Low Cost Graft Fixation Procedures in Pterygium Surgery in a Developing Country

S. Kodavoor, Raline Solomon Amalakaran, D. Ramamurthy
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引用次数: 1

Abstract

Aim: To compare surgical outcomes of pterygium excision with conjunctival autograft using Sutures and Autologous blood for primary pterygium. Materials and methods: Retrospective study done in 404 eyes with primary pterygium. Excision of the pterygium and conjunctival autograft fixation using sutures (group 1) or Autologous blood (group 2). Graft related complications such as recurrence, graft loss, graft retraction, granuloma were noted and compared between the two groups. Result: The average time taken for surgery was 10.66 ± 0.89 (group 1) and 10.44 ± 0.77 (group 2) (p=0.009). The recurrence rate following pterygium surgery was noted in 5eyes (2.5%) in group 1, and 10 eyes (4.9%) in group 2. Graft retraction was seen in 13 eyes in group 1,57 eyes in group 2, of the eyes with graft retraction only 2 eyes in group 1, and 7 eyes in group 2 developed recurrence (p=0.763). Graft loss was seen in 3eyes (1.49%) and in 7eyes (3.44%) in group 2, all patients who developed graft loss developed graft recurrence. Granuloma formation was seen in 2 eyes (0.99%) in group 1 and in 1eye (0.49%) in group 2. The cost of pterygium surgery using glue and autologous blood for conjunctival autograft fixation is much less than procuring and using fibrin glue. Conclusion: Fixing of graft and suturing it in place is important to prevent recurrence. Duration of surgical procedure is comparable. Recurrence and retraction rates are slightly higher in autologous blood group, but not statistically significant. Hence both sutures and autologous blood are very good treatment options for our patients with primary pterygium.
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发展中国家翼状胬肉手术中两种低成本移植固定方法的比较分析
目的:比较原发性翼状胬肉切除与自体结膜吻合术治疗翼状胬肉的疗效。材料与方法:对404只原发性翼状胬肉进行回顾性研究。切除翼状胬肉,用缝线或自体血固定自体结膜(组1)。观察并比较两组之间的移植物相关并发症,如复发、移植物丢失、移植物缩回、肉芽肿。结果:平均手术时间为10.66±0.89(第一组),10.44±0.77(第二组)(p=0.009)。术后复发率1组5眼(2.5%),2组10眼(4.9%)。1组13只眼出现移植物缩回,2组57只眼出现移植物缩回,1组2只眼出现移植物缩回,2组7只眼出现复发(p=0.763)。2组3眼(1.49%)和7眼(3.44%)出现移植物丧失,所有发生移植物丧失的患者均出现移植物复发。1组2眼(0.99%)出现肉芽肿,2组1眼(0.49%)出现肉芽肿。翼状胬肉手术中使用胶水和自体血液进行自体结膜固定的费用远低于获取和使用纤维蛋白胶。结论:植骨固定和缝合是预防复发的重要手段。手术过程的持续时间是可比的。自体血型患者的复发率和回缩率略高,但无统计学意义。因此,缝合和自体血液对我们的原发性翼状胬肉患者来说都是很好的治疗选择。
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