Purpose: To compare the efficacy and safety of electrocautery pen (ECP) with nylon 10-0 sutures in conjunctival autografting for the treatment of primary pterygium.
Methods: A prospective, randomized, clinical trial was carried out in 80 patients (80 eyes) with primary pterygium. Patients were randomized to undergo pterygium surgery using either ECP (40 eyes) or nylon 10-0 sutures (40 eyes) to attach the conjunctival autograft. All the patients were followed up postoperatively on postoperative days 1, 2, 3, 5, 7, and 14 and then at months 1, 3, 6, and 12. Outcome measures were surgery time, postoperative patient discomfort, complications, and recurrence rate.
Results: The mean surgical time for the glue group was significantly shorter at 20.4 minutes compared with the suture group at 27.1 minutes (P < 0.001). Postoperative pain, irritation, and epiphora were significantly less at postoperative days 5 and 7 (P < 0.05). Postoperative foreign body sensation was significantly less at postoperative days 2, 3, 5, and 7 (P < 0.05). Two patients in the ECP group had partial graft dehiscence; 2 patients in the suture group developed granulomas. During the follow-up period, conjunctival recurrence (grade 3) developed in 1 (2.5%) eye in the ECP group, and in 2 (5%) eyes in the suture group. Both groups had 1 (2.5%) corneal recurrence (grade 4).
Conclusion: Using ECP for the attachment of conjunctival autograft in pterygium surgery is safe, fast, simple, and economical with less postoperative discomfort.