Comparison between sutureless and glue free versus sutured limbal conjunctival autograft in primary pterygium surgery

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery: a technique note

AIM

To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation.

METHODS

Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability.

RESULTS

Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min vs 18.15±2.20min, P=0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) vs 3.00min (2.21-4.15), P<0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (P<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) vs 2 (1-4), P<0.001]. Postoperative symptoms at 6mo were comparable between the groups (P=0.487), with no recurrence.

CONCLUSION

ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.

Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis

BACKGROUND

Pterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis compared the modified sutureless glue-free (MSGF) method with conventional sutures (CS) for conjunctival autograft fixation in primary pterygium surgery.

METHODS

A comprehensive search was conducted in MEDLINE, Embase, CENTRAL, Google Scholar and ClinicalTrials.gov for randomised controlled trials (RCTs) comparing MSGF and CS conjunctival autografts. Outcome measures included operation time, recurrence and postoperative complications. Standardised mean difference (SMD) and risk ratio (RR) were used for continuous and dichotomous outcomes, respectively.

RESULTS

11 RCTs involving 833 participants were included. The analysis revealed that MSGF had a significantly shorter operation time compared with CS (SMD -3.704, 95% CI -5.122 to -2.287, p<0.001). CS was associated with a higher risk of foreign body sensation (RR 0.22, 95% CI 0.06 to 0.74, p=0.01). MSGF was associated with a higher risk of graft dehiscence (RR 9.01, 95% CI 2.74 to 29.68, p=0.000) and graft retraction (RR 2.37, 95% CI 1.17 to 4.77, p=0.02). No significant differences were found in recurrence, graft haemorrhage, granuloma, Dellen and conjunctival oedema.

CONCLUSION

Using the MSGF technique in conjunctival autograft fixation for pterygium surgery reduces operation time by relying solely on the patient's blood for fixation. However, it increases the risk of graft dehiscence and retraction. However, CS is linked to a higher likelihood of experiencing foreign body sensations. Understanding the learning curve and surgeon familiarity with novel techniques is crucial for optimising patient care and surgical outcomes, while individualised decision-making is necessary considering the advantages and disadvantages of each approach. Further research is warranted to minimise complications and optimise surgical outcomes.

Evaluation of the Efficacy of Different Pterygium Surgeries in Polish Caucasian Population

The aim of the study was to compare the efficacy of the two most commonly used surgical methods for pterygium removal in the Polish population, conjunctival autograft versus amniotic membrane transplantation, and to evaluate the postoperative recurrence rate. A retrospective analysis of the medical records was conducted, including 65 patients who underwent surgery for primary or recurrent pterygium at an ophthalmology clinic in Bialystok, Poland, between 2016 and 2020. Surgical success (no regrowth) was achieved in almost half of the amniotic membrane patients (44%) and in most of the conjunctival autograft patients (79%), with statistical significance. The odds of successful surgery were 79% lower for subjects with amniotic membranes than for those with conjunctival autografts (OR with 95% CI = 0.21 (0.05; 0.94); $p=0.045$ ). Our study confirms that the conjunctival autograft surgeries present more favorable success rates in Polish Caucasian population when compared to procedures involving amniotic membranes.

Membrane of Plasma Rich in Growth Factors in Primary Pterygium Surgery Compared to Amniotic Membrane Transplantation and Conjunctival Autograft

This prospective and comparative study aimed to compare the use of a conjunctival autograft (CAG), plasma rich in growth factors fibrin membrane (mPRGF) or amniotic membrane transplantation (AMT) in primary pterygium surgery. Patients were assigned for surgery with CAG (group A), mPRGF (group B), or AMT (group C). Pterygium recurrence, Best Corrected Visual Acuity (BCVA), graft size (measured with anterior segment optical coherence tomography (AS-OCT)), and ocular surface symptoms (visual analogue scale (VAS) and ocular surface disease index (OSDI)) were evaluated. Thirteen eyes in group A, 26 in group B, and 10 in group C were evaluated. No changes in BCVA (p > 0.05) were found. Recurrence cases for groups A, B, and C were none, two, and two, respectively, and three cases of pyogenic granulomas in group A. The horizontal/vertical graft size was lower in group B vs group A (p < 0.05) from months 1 to 12. The improvement in VAS frequency for groups A, B, and C was: 35.5%, 86.2%, and 39.1%, respectively. The OSDI scale reduction for groups A, B, and C was: 12.7%, 39.0%, and 84.1%. The use of the three surgical techniques as a graft for primary pterygium surgery was safe and effective, showing similar results. The mPRGF graft represents an autologous novel approach for pterygium surgery.

Clinical Outcomes of Silk versus Nylon Sutures for Suturing of Conjunctival Autograft in Pterygium Surgery

PURPOSE:

The purpose is to compare the clinical results of using silk versus nylon sutures for conjunctival autograft suturing in pterygium surgery.

METHODS:

In this prospective, randomized, controlled, clinical trial 50 eyes from 50 patients with primary nasal pterygium were randomized to undergo pterygium surgery with the use of either nylon sutures or silk sutures for conjunctival autograft suturing. Patients were followed up for 6 months. Main outcome measures included recurrence, postoperative discomfort according to a visual analog scale (VAS), graft hyperemia, and graft edema.

RESULTS:

According to the results, there was no significant difference between groups regarding recurrence rate of pterygium (P = 0.72). A significant decrease in the mean VAS discomfort score from day 1 to day 14 was observed in both groups (P = 0.001); postoperative discomfort during the first 2 weeks, was not significantly different between the two groups. At 2 weeks' postoperatively, significantly greater number of nylon sutures remained on the autograft (P = 0.021), some of which were buried and could not be removed.

CONCLUSION:

Both silk and nylon are effective suture materials for autograft suturing in pterygium surgery with similar postoperative discomfort and recurrence rate. Significantly greater number of nylon sutures remains buried on the autograft and could not be removed easily.

Modified Sutureless and Glue-Free Method Versus Conventional Sutures for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Randomized Controlled Trial

PURPOSE

To compare the advantages and disadvantages of a modified sutureless and glue-free method with those of conventional sutures for conjunctival autograft fixation in pterygium surgery.

METHODS

A prospective randomized controlled study was performed on 73 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a limbal conjunctival autograft, which was fixed using a modified sutureless and glue-free method in group 1 (39 eyes) and sutures in group 2 (34 eyes). The main outcome measures were operative time, autograft stability, postoperative discomfort, autograft thickness, pterygium recurrence, and complications.

RESULTS

The mean operative time was significantly shorter in group 1 (11.9 ± 1.3 minutes) than in group 2 (24.3 ± 6.1 minutes, P < 0.0001). On day 2 postsurgery, the average conjunctival autograft thickness was significantly higher in group 1 (861 ± 340 μm) than in group 2 (577 ± 287 μm, P = 0.034). Subsequently, conjunctival autograft thickness gradually decreased, with no significant difference between groups after 1 week. There were no significant differences in postoperative discomfort between groups, except for a greater foreign body sensation on day 2 and an itching sensation in 1 week in group 2 compared with group 1. Autograft side displacement occurred in 4 patients (10.3%) in group 1; 2 of these 4 developed a granuloma. There was 1 recurrence (2.9%) in group 2.

CONCLUSIONS

The modified sutureless and glue-free limbal conjunctival autograft fixation method might be effective and efficient for primary pterygium surgery, with potentially decreased recurrence and postoperative discomfort.

Efficacy of Autologous Serum in Fixing Conjunctival Autografts of Various Sizes in Different Types and Grades of Pterygium

Purpose:

To evaluate the efficacy of autologous serum in fixing conjunctival autografts of various sizes in different grades and types of pterygium and to determine the largest successfully secured graft size.

Methods:

This prospective interventional study comprised 151 eyes of 151 patients belonging to age group of 21 to 64 years with different grades and types of primary and recurrent pterygium that underwent excision with inferior conjunctivo - limbal autograft secured with autologous serum. The autografts were measured with calipers and were grouped by size into three categories: Group A, small (5 × 5 mm); Group B, medium (5–7 × 5 mm); and Group C, large (>7 × 5 mm). The adhesive fixation power of autologous serum for the various conjunctival autograft sizes was determined for each group using the following criteria: graft stability, cosmetic appearance and complications in the immediate ( first week) and two-months postoperative follow-up visits. Descriptive statistical analysis was used to calculate the percentage frequency of the variables.

Results:

The groups A, B, and C included 48%, 22%, and 30% of the autografts, respectively. Overall, 93.34% of the grafts were stable with good cosmetic appearance. However, subconjunctival hemorrhage (36%), graft edema (36%) and graft retraction (13.5%) were the most common complications. The largest successfully fixed graft was 14 × 5 mm in size.

Conclusion:

Autologous serum is efficient in securing conjunctival autografts of various sizes with minimal complications and satisfactory results, including good cosmesis.

Early postoperative outcomes of pterygium surgery: Sutures versus autogenous serum in-situ fixation of limbal conjunctival autograft

Limbal Conjunctival Autograft Transplantation (LCAT) is considered to be the most effective treatment option for pterygium with the least recurrence rate and rapid restoration of normal epithelial morphology. Of the many available methods for securing Limbal Conjunctival Autograft (LCAG), sutures and autogenous serum in-situ are cost-effective and offers better outcomes.

AIM

To compare the outcome of surgeries between the two groups: Group I - LCAG secured with autogenous serum in-situ versus Group II - LCAG secured with sutures.

MAIN METHODS

A prospective randomized control trial conducted on 60 patients who were equally divided into two groups. Post-operative follow-up visits were scheduled at 1st week, 3rd week and 6th week. They were examined for pain, foreign body sensation, subconjunctival hemorrhage, tearing, hyperemia, graft edema, graft displacement, graft retraction, recurrence and/or any other complications and were graded depending on the severity. Mean surgical time was compared between the two groups.

KEY FINDINGS

Average duration of surgery was significantly less in Group I than in Group II. Postoperatively, symptoms like pain, foreign body sensation, tearing and hyperemia were less common in Group I, furthermore subconjunctival hemorrhage and graft edema were more in Group II.

SIGNIFICANCE

Though both the procedures are safe and effective, the use of autogenous serum in-situ significantly shortens the duration of surgery and is accompanied by lesser postoperative discomfort and inflammation. However, long-term studies are needed to assess the risk of recurrence. Graft displacement remains a severe, but infrequent complication.

[Pterygium surgery by conjunctiva autograft with autologous blood fixation]

INTRODUCTION

Pterygium surgery is marked by the possibility of recurrences; one of the techniques which results in the least recurrences is conjunctival autograft. Fixation of the conjunctiva had traditionally been accomplished with sutures. In recent years, conjunctival grafting has also been performed with fibrin glue. Even more recently, with a view towards improving the quality of postoperative results, some surgeons recommend the use of autologous blood. This study aims to evaluate the stability of this latest method of graft fixation, while assessing its postoperative results.

METHODOLOGY

After diagnosis of pterygium, the patients underwent pterygium surgery with a conjunctival graft fixated with autologous blood. They were then monitored for one year, at 24h postoperatively, then seven days, 15 days, one month 3months, and every 3months thereafter.

RESULTS

In totl, 84.21 % of the patients demonstrated stable postoperative fixation; 5.26 % of patients experienced significant displacement of the graft. After one year of follow-up, 15.79 % of patients experienced recurrent pterygium. Recurrences were more frequent in younger patients and in patients with previous recurrence.

CONCLUSION

Pterygium surgery by conjunctival graft fixated with autologous blood is a safe surgery, with results similar to other pterygium surgery techniques with conjunctival autograft. However, this technique has the advantage less irritation, no risk of transmitting infection and lower cost.

Outcomes of pterygium surgery-glue versus autologous blood versus sutures for graft fixation-an analysis

AIM:

The aim of this study is to compare the surgical outcomes of pterygium excision with conjunctival autograft using sutures, fibrin glue (tisseel), and autologous blood for the management of primary pterygium.

PATIENTS AND METHODS:

A retrospective study done in 681 eyes with primary nasal pterygium. Excision of the pterygium was performed followed by closure of the bare sclera with conjunctival autograft using interrupted 10-0 monofilament nylon sutures in 173 eyes (Group 1), fibrin glue (tisseel-baxter healthcare corporation, westlake village, ca-91362 USA) in 351 eyes (Group 2), and autologous blood in 157 eyes (Group 3). Patients were followed up for a period of 5–52 months. During follow-up, graft-related complications such as recurrence, graft loss, graft retraction, granuloma if any were noted and compared among the three groups.

RESULTS:

A total of 681 eyes who had primary nasal pterygium were included in this study. Pterygium excision with conjunctival autograft was performed using 10-0 monofilament nylon interrupted sutures in 173 eyes (25.4%), tisseel fibrin glue in 351 eyes (51.54%), and autologous blood in 157 (23.05%) eyes. The mean duration of follow-up was 5–52 months. The overall recurrence rate was 2.9% (20 eyes). In Group 1, recurrence was seen in 5 eyes (2.89%), in Group 2, it was seen in 7 eyes (1.99%) and in Group 3, 8 eyes (5.10%). However, the recurrence rate was not significant (P = 0.160). The rate of graft retraction in the 3 study groups were 12 eyes (6.94%), 10 eyes (2.85%), and 56 eyes (35.67%) with a significant P < 0.001. Granuloma was seen in 2 eyes (1.16%), in Group 1, and in 1 eye (0.64%) in Group 3. Graft loss was seen in 3 eyes (1.73%), 4 eyes (1.14%), 6 eyes (3.82%) in Group 1, 2, and 3, respectively.

CONCLUSION:

The outcomes of the three most commonly performed surgical technique of conjunctival autograft fixation has shown us that all three techniques are equally comparable and can be offered to our patients with equally good results.

Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial

Background

Pterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence.

Objective

to compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation autograft (CRA) and conjunctival autograft (CA), in treating pterygium.

Methods

This randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21.

Results

The mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation’s outcome (p=0.017).

Conclusion

CRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva.

Clinical trial registration

The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016092119581N2.

Funding

The study was financially supported by Shiraz University of Medical Sciences (SUMS) (grants No. 8901).

Sutureless, Glue-less Conjunctival Autograft versus Conjunctival Autograft with Sutures for Primary, Advanced Pterygia: An Interventional Pilot study

INTRODUCTION

Conjunctival Autograft (CAG) in pterygium surgery can be attached by sutures or fibrin glue or autologous in situ blood coagulum. Recurrence rate and other parameters related to pterygium surgery between CAG with sutures and autologous in situ blood coagulum have not been compared uniformly in advanced pterygia alone.

AIM

To compare and evaluate the outcome of sutureless, glue-less CAG with autologous in situ blood coagulum versus CAG with sutures for primary, advanced pterygium.

MATERIALS AND METHODS

Thirty eyes of 30 patients with primary, nasal, advanced, Grade 3 pterygia (as per Tan et al's., classification) were randomized into Group 1 (n=15) (sutureless, glue-less CAG with autologous in situ blood coagulum) and Group 2 (n=15) (conjunctival autograft with 8-0 vicryl sutures) as a pilot study. The outcome parameters evaluated were graft stability and symptoms of pain, foreign body sensation and watering at day 1, day 7, day 14, one month, three months and six months and recurrence at six months.

RESULTS

The mean age in the study was 44.77±13.74 years. Overall, Group 1 had better scores in symptom parameters than Group 2 (p<0.05). Graft stability was better in Group 2 (p<0.05). In Group 1, 3 (20%) patients had one side displacement and 3 (20%) patients had full displacement of graft. At six months, 4 (26.6%) patients in Group 1 had recurrence whereas in Group 2, 5 patients (33.3%) had recurrence (p=0.446).

CONCLUSION

In primary, advanced pterygia, sutureless, glue-less pterygium surgery with autologous in situ blood coagulum was better in symptom scores but graft stability was better in the suture group. Sutureless, glue-less pterygium surgery with autologous in situ blood coagulum was unpredictable in graft stability. There was no statistically significant difference in the recurrence rate between the two groups.

Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery

BACKGROUND

Pterygium, a growth of the conjunctiva over the cornea, is a progressive disease leading in advanced stages to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Currently the best surgical option in terms of recurrence is conjunctival autograft. To date the most common surgical methods of attaching conjunctival autografts to the sclera are through suturing or fibrin glue. Each method presents its own advantages and disadvantages. Sutures require considerable skill from the surgeon and can be associated with a prolonged operation time, postoperative discomfort and suture-related complications, whereas fibrin glue may give a decreased operation time, improve postoperative comfort and avoid suture-related problems.

OBJECTIVES

To assess the effectiveness of fibrin glue compared to sutures in conjunctival autografting for the surgical treatment of pterygium.

SEARCH METHODS

We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2016), Embase (January 1980 to October 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 October 2016.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) in any setting where fibrin glue was compared with sutures to treat people with pterygium.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened the search results, assessed trial quality, and extracted data using standard methodological procedures expected by Cochrane. Our primary outcome was recurrence of pterygium defined as any re-growth of tissue from the area of excision across the limbus onto the cornea. The secondary outcomes were surgical time and complication rate. We graded the certainty of the evidence using GRADE.

MAIN RESULTS

We included 14 RCTs conducted in Brazil, China, Egypt, India, Malaysia, New Zealand, Philippines, Saudi Arabia, Sweden and Turkey. The trials were published between 2004 and 2016, and were assessed as a mixture of unclear and low risk of bias with three studies at high risk of attrition bias. Only adults were enrolled in these studies.Using fibrin glue for the conjunctival autograft may result in less recurrence of pterygium compared with using sutures (risk ratio (RR) 0.47, 95% CI 0.27 to 0.82, 762 eyes, 12 RCTs; low-certainty evidence). If pterygium recurs after approximately 10 in every 100 surgeries with sutures, then using fibrin glue may result in approximately 5 fewer cases of recurrence in every 100 surgeries (95% CI 2 fewer to 7 fewer cases). Using fibrin glue may lead to more complications compared with sutures (RR 1.92; 95% CI 1.22 to 3.02, 11 RCTs, 673 eyes, low-certainty evidence). The most common complications reported were: graft dehiscence, graft retraction and granuloma. On average using fibrin glue may mean that surgery is quicker compared with suturing (mean difference (MD) -17.01 minutes 95% CI -20.56 to -13.46), 9 RCTs, 614 eyes, low-certainty evidence).

AUTHORS' CONCLUSIONS

The meta-analyses, conducted on people with pterygium in a hospital or outpatient setting, show fibrin glue may result in less recurrence and may take less time than sutures for fixing the conjunctival graft in place during pterygium surgery. There was low-certainty evidence to suggest a higher proportion of complications in the fibrin glue group.

Sutureless and Glue-free Versus Sutures for Limbal Conjunctival Autografting in Primary Pterygium Surgery: A Prospective Comparative Study

INTRODUCTION

Sutureless and glue-free conjunctival autograft as a treatment modality for primary pterygium is recently gaining popularity but conventional technique of suturing conjunctival autograft is still practised widely.

AIM

To compare the outcome of sutureless and glue-free technique with sutures for limbal conjunctival autografting in management of primary pterygium.

MATERIALS AND METHODS

A prospective interventional study was carried out in 50 consecutive eyes with primary nasal pterygium requiring surgical excision. Simple excision under local anaesthesia was performed followed by closure of the bare sclera by sutureless and glue-free conjunctival autograft in 25 eyes of 25 patients (group 1) and by the conventional method of suturing conjunctival autograft using interrupted 10-0 nylon sutures in 25 eyes of 25 patients (group 2), followed by bandaging for 24 hours in both the groups. Surgical time was recorded for both the techniques. Postoperative discomfort was assessed using preformed questionnaires. The patients were followed up for 6 months. During follow up, graft related complications and recurrence if any were noted.

RESULTS

Mean surgical time for group 1 (23.20±1.55 minutes) was significantly less as compared to group 2 (37.76±1.89 minutes); (p=0.001). Postoperative symptoms were seen in less number of patients (20%) and were of shorter duration (2 weeks) in group 1 as compared to group 2 with 20 (80%) patients having symptoms lasting for 4 weeks; (p<0.001). Recurrence rate and conjunctival granuloma formation rate for group 1 (0%) and for group 2 (4%) were statistically insignificant.

CONCLUSION

Sutureless and glue-free conjunctival autograft technique is simple, easy, safe, effective and less time consuming than sutured limbal autograft technique with less postoperative discomfort and adverse events encountered with the use of suture material. Postoperative results of both techniques are comparable. Hence sutureless and glue-free conjunctival autografting is a good technique for the treatment of primary pterygium.

Outcome of different techniques of pterygium excision with conjunctival autografting in pediatric population: Our experience in central India

Aim:

To analyze surgical outcome of pterygium excision with conjunctival autografting in pediatric population ≤16 years.

Settings and Design:

Retrospective case series.

Materials and Methods:

A case sheet review of 145 patients (167 eyes) aged ≤16 years consecutively presented with pterygium from April 2008 to August 2014 in the single center was done. Twenty-six eyes of 25 children who underwent pterygium excision with conjunctival autograft were analyzed. Different techniques used to secure conjunctival autograft in a position were multiple interrupted 8-0 vicryl sutures, single 8-0 vicryl suture in the center of graft and sutureless glue free. Outcome measures were a failure of surgery and recurrence.

Results:

Of the total 167 eyes, 26 eyes of 25 children, mean age 13.07 ± 3.08 years (range 7–16 years) were managed surgically with pterygium excision and conjunctival autograft. The rest of the patients were managed conservatively. In 18 eyes, the graft was secured with multiple sutures, in 6 eyes with a single suture, whereas in 2 eyes, sutureless glue-free graft opposition was done. Mean follow-up was 8.03 months. No case of graft retraction, graft dehiscence or graft displacement was found. Recurrence occurred in 6 eyes and managed surgically.

Conclusions:

Occurrence of pterygium is not uncommon in the pediatric population. A single suture or sutureless glue-free technique may be good alternative for securing conjunctival autograft after pterygium excision in children.