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Superior Versus Inferior Conjunctival Autografts Combined With Fibrin Glue in the Management of Primary Pterygia

Yeung, Sonia N. MD, PhD, FRCSC; Lichtinger, Alejandro MD; Kim, Peter MBBS (Hons) FRANZCO; Elbaz, Uri MD; Ku, Judy Y.F. MBBS, FRANZCO; Amiran, Maoz D. MD; Gorfinkle, Nathan MD; Wolff, Rachel MD; Slomovic, Allan R. MA, MD, FRCSC

doi: 10.1097/ICO.0b013e3182a9e712
Clinical Science

Purpose: To compare the outcomes of superior versus inferior conjunctival autograft (CAU) in the prevention of recurrence after performing a pterygium surgery in patients with primary pterygia.

Methods: This was a prospective randomized study of 60 eyes of 60 patients with primary pterygium. All the eyes underwent pterygium excision and were assigned randomly to receive either superior (30 eyes) or inferior (30 eyes) CAU. All grafts were attached with fibrin glue. The patients were followed up on postoperative day 1, day 7, 1 month, 3 months, and 6 months.

Results: Outcome measures included rate of recurrence, mean surgical time, visual analog scale pain score, and amount of pain medication required in the first postoperative week. The mean surgical time, visual analog scale pain score, and amount of pain medication required in both groups were not statistically different. A follow-up of at least 6 months (mean 5.5 ± 1.1 months) was achieved in 49 eyes of 49 patients (24 eyes in the superior CAU group and 25 eyes in the inferior CAU group). One eye in the superior CAU group (4.2%) and 1 eye in the inferior CAU group (4.0%) developed pterygium recurrence. There was no statistically significant difference in the recurrence rates between the 2 groups. In the inferior CAU group, mild localized donor site scarring was noted in 2 patients (8.3%).

Conclusions: Pterygium excision with superior or inferior CAU secured with fibrin glue is safe and effective. There was no significant difference in surgical time, pain, and recurrence rates of pterygium after excision with superior or inferior CAU.

*Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, ON; and

Department of Ophthalmology, University of British Columbia, Vancouver, BC.

Reprints: Sonia N. Yeung, Department of Ophthalmology, University of British Columbia, Vancouver Hospital, Eye Care Centre, 2550 Willow St, Vancouver, BC V5Z 3N9 (e-mail: sonia.y@gmail.com).

The authors have no funding or conflicts of interest to disclose.

Received July 11, 2013

Accepted August 22, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.