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A prospective observational study on the effectiveness of pterygium excision with limbal conjunctival autograft transplantation and recurrence in patients of primary pterygium

Dibyendu Dhali, Nabanita Barua, Sanjay Kumar Daulat Thakur, Debabrata Das, Pramit Ghosh, Ranjita Santra.




Abstract

Background: Pterygium is a degenerative and hyperplastic process with abnormal fibrovascular proliferation. Surgery is the treatment of choice in progressive or symptomatic cases but recurrence is a concern.

Aims and Objective: We aim to evaluate the effectiveness of pterygium excision and conjunctival autograft (done by post-graduate trainees in the 2nd and 3rd year of residency under supervision) and recurrence of this process in a tertiary care setup.

Materials and Methods: It is a single-centric prospective observational study. 50 patients who underwent pterygium excision with conjunctival autografting surgery in a tertiary care hospital were followed up for 1 year. Patients were evaluated on day 1, day 7, 1 month, 6 months, and 1 year. Efficacy and graft stability were assessed on day 7 and 1 month; 6 months and 1 year for recurrence and the factors associated with it.

Results: Total number of patients was 50; 31 were female, and 19 were male. All cases were effectively managed with excision and autograft. Post-operatively, 13 (26%) patients had shown suture loosening, 17 (34%) patients had graft edema, and 13 (26%) patients had post-operative recurrence. Out of 13 patients, 8 patients had mild recurrence, 4 patients had moderate recurrence, and 1 patient had severe recurrence. Graft stability is significantly associated with suture loosening (P < 0.05). There is no association between the extent and grade of pterygium (P > 0.05). Recurrence was statistically highly associated with (P < 0.0001) suture loosening.

Conclusion: We conclude that autografting is an effective technique. Intraoperative proper suturing technique and minimal tissue manipulation can minimize recurrence.

Key words: Conjunctival Autograft; Recurrence; Effectiveness Of Autografting






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