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

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.