Madhuri Upadhyaya1, Sheetal Savur2
BACKGROUND
Pterygium excision with conjunctival limbal autograft (CAU) is one of the most
frequently used modalities in the treatment of pterygium. The graft has
traditionally been harvested from the superior bulbar conjunctiva, but this may not
be possible in all patients. The purpose of this study was to compare the
intraoperative difficulties and early postoperative outcomes between superior and
inferior CAU in the management of primary pterygium.
METHODS
This hospital based cross sectional study evaluated 58 eyes of 50 patients with
primary pterygium who underwent pterygium excision with conjunctival limbal
autograft secured with the help of sutures over a period of 2 years from March
2018 to March 2020. In 28 eyes, the superior bulbar conjunctiva was used for
grafting whereas in 30 eyes, the inferior conjunctiva was used for the same. The
outcome measured was in terms of the mean surgical time, clinical symptoms and
signs in the early postoperative period and recurrence rate.
RESULTS
The mean age of the patients was 44.14 ± 12.71 years in the superior CAU group
and 45.76 ± 14.51 years in the inferior CAU group. There was no statistically
significant difference between the two groups in terms of the mean surgical time
(68.39 ± 31.51 in superior group, 2.60 ± 0.79 in inferior group; P value 0.712).
The duration of follow-up after surgery was significantly more (P = 0.048) in the
inferior CAU group (42.60 ± 11.71 days) as compared to the superior CAU group
(37.39 ± 7.52 days). Postoperative symptoms were comparable, and no
recurrence was observed in either of the two groups.
CONCLUSIONS
Pterygium excision with inferior conjunctival limbal autograft is safe and effective
in the management of primary pterygia and may be considered as an alternative
to superior graft in cases where harvesting the superior conjunctiva is not possible
or not advisable.
