Comparative study of sutureless and glue-free versus conjunctival autograft with sutures in primary pterygium surgery

Context: Sutureless glue-less surgery (SGF) is a newer alternative to the conventional conjunctival autograft with sutures (CAGS) techniques used for pterygium surgery. Aims and Objectives: To compare the safety, efficacy, and complications of SGF technique versus CAGS in the management of primary pterygium. Subjects and Methods: We performed a hospital based prospective study among 46 patients who underwent pterygium excision during an 18-month period from 2017 to 2018. Results: The duration of SGF procedure was <15 min with fewer incidences of overall symptoms postoperatively (P < 0.001) which were significantly higher in the CAGS group. The duration of symptoms was 4 days for SGF and 4 weeks for CAGS group. Although signs like graft edema and retraction were more in the SGF group in the immediate postoperative period, it resolved by 6 weeks. Three cases of recurrence were noted in the SGF group, but this was statistically insignificant. No graft loss occurred. Paired t-test showed that there is a significant reduction in astigmatism and improvement in keratometric values in both groups, with greater change in SGF group, however, this was not statistically significant. Conclusion: Sutureless and glue-free technique is a safe, effective, time-saving, and economical option for the management of pterygium with less postoperative symptoms. SGF has more postoperative signs which resolved in 6 months. The recurrence rate was higher in SGF but within the expected range reported in the literature.