A COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF AUTOLOGOUS FIBRIN (BLOOD), FIBRIN GLUE AND SUTURES IN CONJUNCTIVAL AUTOGRAFT FOR PTERYGIUM EXCISION

BACKGROUND Pterygium, a growth of fibrovascular tissue on the cornea, which appears to be continuous with conjunctiva. Its treatment is mainly surgical. AIMS AND OBJECTIVES To compare three surgical techniques in management of pterygium. STUDY DESIGN Prospective randomised interventional study. MATERIALS AND METHODS The study was conducted from November 2013 to November 2015 at the Department of Ophthalmology, GMC, Haldwani, Uttarakhand. All the patients of primary nasal pterygium who came in OPD were selected for surgical intervention. A total number of 75 eyes (75 patients) undergoing pterygium excision with conjunctival autograft were taken and randomly allocated to three groups: Autograft using autologous blood (Group A, 23 patients), Autograft using fibrin glue (Group F, 21 patients) and Autograft using sutures (Group S, 31 patients). The three groups were compared for: duration of surgery, postoperative discomfort and complications. RESULTS The duration of surgery was longer in group A (23.73 +/- 1.05 min.) and S (25.51 +/- 3.01 min.) as compared to group F (20.22 +/- 0.8 min). In Group S, 15 patients (48.38%) reported moderate postoperative discomfort on day 1 and also for the longest duration. Graft oedema was comparable in the three groups. Graft displacement was seen in 1 patient of group A (4.34%). CONCLUSION Three surgical techniques used in study are equally effective, but have their own merits and demerits. Postoperative discomfort and suture related complication remains a drawback in suture group. Fibrin glue possesses less complication, but affordability is an issue. Autologous blood is cost effective, has less postoperative discomfort, but graft displacement remains a concern.