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.