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Suture or sutureless technique to compare the surgical outcome and patient comfort with dry amniotic membrane and conjunctival limbal autograft in primary pterygium surgery
Objective: To compare the intraoperative and post-operative complications with dry amniotic membrane transplantation and conjunctival limbal autograft and to assess the patient comfort between the two surgeries in primary pterygium. Method: This randomized, open labeled, parallel group and prospective study enrolled 80 patients above 18 years attending the ophthalmic OPD with primary pterygium. The eligible participants were randomized into four groups. Group-A: Conjunctival limbal autograft with autologous serum, Group-B: Conjunctival limbal autograft with suture, Group-C: Amniotic membrane transplantation with autologous serum, Group-D and Group-C Amniotic membrane transplantation with Suture. Patient assessment was done intraoperatively, postoperative day 1, week 1 and week 6 for ocular signs and symptoms. Adverse events were recorded. The statistical analysis was done using Chi square test and Wilcoxon signed rank test. Results: Surgical outcome-graft tear (4.20%) and button hole (3.15%) were higher in suture techniques and graft loss (1, 5%) was seen in Group-B. Congestion (25, 62.5%) and graft edema (12.30%) was more with suture techniques, maximum recurrence was seen in Group-A (5.25%) and Group-B (4.25%). Patient comfort was highest in suture less technique with significant p value (0.012). At week 6, a significant reduction in the mean scores was seen in all the four groups. Conclusion: Conjunctival limbal autograft with autologuos serum is the best technique for pterygium surgery with few complications, recurrences and good patient comfort. However, amniotic membrane transplantation can be reserved for patients with glaucoma
Biography
Meghana Patil has completed her MBBS, MS in Ophthalmology and FCPRS Fellowship in Cornea and Phacorefractive Surgery. She is currently an Assistant Professor at the Department of Ophthalmology, J.J.M Medical College, India.
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