Pterygium excision with conjunctival autograft using autologous in SITU blood coagulum as bioadhesive

Abstract

Aim: To evaluate the outcomes of pterygium excision with conjunctival autograft using autologous in situ blood coagulum. Materials and Methods: This is a prospective study of 50 eyes of 50 patients after taking informed consent, operated between May 2017 and October 2018 in the Department of Ophthalmology, Narayana Medical Hospital, Nellore. The study included 21 males and 29 females. Following pterygium excision, 1 mm oversized donor conjunctival graft was taken and placed over bare sclera, maintaining limbus to limbus polarity. The surgeon waited for 5-7 minutes to allow time for hemostasis and stabilization of graft. Results: Complications observed were graft edema in 4 cases (8%), graft retraction in 1 case (2%), subgraft haemorrhage in 2 cases (4%). Commonly encountered complications were subconjunctival haemorrhage, chemosis, congestion, discomfort, corneal scarring, corneal epithelial defects, and inadequate sized grafts. Recurrence or dehiscences were not noted. Conclusion: This study of using autologous blood coagulum for pterygium fixation showed this method to be more effective, less time consuming than suturing grafts, and more economical and free from the risk of contagious diseases compared to fibrin glue. The occurrence of very minimal complications and the swift resolution of any encountered complications makes this a superior approach.