RESEARCH PAPER
Autologous blood as tissue adhesive for conjunctival autograft in primary nasal pterygium surgery
More details
Hide details
1
Nizamabad Medical College, Nizamabad, Telengana, India
Corresponding author
Kiran Beesam
Nizamabad Medical College, Flat no 312,near indian bank,attapur, pillar no 118, 500048 Hyderabad, India
J Pre Clin Clin Res. 2018;12(2):51-53
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Pterygium is defined as a triangular fibrovascular growth of connective tissue covered with conjunctival epithelium which extends over the corneal surface from the corneo-scleral margin. Surgical removal is the mainstay treatment with autologous blood used as tissue adhesive to prevent recurrences and scarring.
Objectives:
To describe a simple method of conjunctival autograft adherence during pterygium surgery, and assess the
efficacy of securing limbal conjunctival autograft using the patient’s own blood.
Material and methods:
This is a prospective interventional study conducted from June 2017 – March 2018 in the department
of Ophthalmology at the Government Medical College in Nizamabad, India. After pterygium excision, conjunctival autograft was placed over the sclera bed after attaining haemostasis. Graft adherence was examined 20 minutes after surgery.
Results:
A total 100 patients with pterygium underwent pterygium excision with conjunctival autograft surgery using
autologous blood. There were 45 female and 55 male patients who had primary nasal pterygium, and 65 patients with
progressive pterygium and 35 patients with non-progressive pterygium. Post-operative complications like granuloma
had developed in 3 (3%) patients, 10 (10%) patients had conjunctival haemorrhage, 5 (5%) patients had developed graft dehiscence and retraction. 4 (4%) patients had graft oedema and 2 (2%) patients developed recurrence of pterygium after 3 months. Improvement of visual acuity was observed in 10 patients. Cosmesis was good in all patients
Conclusions:
It could be concluded from this study that using autologous blood as a tissue adhesive for graft fixation is
a useful alternative. This procedure is safe, effective, and economical, with less discomfort and more patient satisfaction.
Risks associated with fibrin glue and suture related problems are avoided.
REFERENCES (11)
1.
Hirst LW,Sebban A,Chant D.Pterygium Recurrence time.Ophthalmology 1994;101:755-8.
2.
Steven G. Kramer, MD.,editor diagnostic and surgical techniques survey of ophthalmology volume 33. July-August 1988;pg:41.
3.
Duke- Elder WS.System of ophthalmology. Vol 8,Part 1.London:Henry Kimpton,1965:573-83.
4.
Sandford-Smith J.Eye diseases in hot climates. Bristol: ELBS/Wright,1987:104-5.
5.
Timothy j.threlfal, MBBS, MPH, and dallas r. english, phd sun exposure and pterygium of the eye: a dose responsive curve American journal of ophthalmology September 1999 pg 280.
6.
Moran DJ,Hollows FC.Pterygium and ultraviolet radiation:a positive correlation.BRr J Ophthalmology 1984;68:343.
7.
Hirst LW.The treatment of pterygium. Surv Ophthalmol 2003;48(2):145-180.
8.
D’Ombrain A.The surgical treatment of pterygium. Br J Ophthalmology1948;32,65-70.
9.
Singh,Punith K.MS,Singh,Subadra MS,Vyas,Chandrashekar MS,Singh,Manju MS;Conjunctival Autografting without fibrin glue or sutures for pterygium surgery;Cornea;2013 volime 32-issue1 p 104-107.
10.
D de Wit,Athanasiadis, A Sharma and J Moore:Sutureless and glue free conjunctival autograft in pterygium surgery:a case series.Eye(2010)24,1474-1477.
11.
Boucher S,Conlon R,Teja S,Teichman JC,yeung S,Ziai S;Fibrin glue versus autologous blood for conjunctival autograft fixation in pterygium surgery;Can J Ophthalmol,2015 AUG;50(4)269-272.