Efficacy of Autologous Blood Clot in Primary Pterygium Surgery Compared With Suture Technique in a Tertiary Hospital of Bangladesh

Abstract

Purpose: The aim of this study is to assess the efficacy among patients undergoing pterygium excision and conjunctival autograft utilizing autologous blood or sutures.

Methods: A randomized controlled trial of 1 year and 5 months, with 60 eyes from 60 patients having primary nasal pterygium. As indicated by inclusion criteria, they were chosen and randomized into two arms for conjunctival autograft: treated arm A (30) with autologous blood and arm B (30) with stitches (10-0 monofilament nylon). Preoperative and postoperative results were assessed and analyzed statistically. Follow-up was done at first, seventh, 1-month, 3-month, and half-year postoperative days. Resulting factors were total surgical time, postoperative comfort, graft stability, and recurrence.

Results: 60 patients; mean age of 46.77 ± 7.04 (SD) in arm A (30) and 46.17±7.53 (SD) in arm B (30). In arm A, 22 males (73.3%) and 8 females (26.7%) where arm B had 20 males (66.7%) and 10 females (33.3%). Total surgical time in arm A was 24.73 ± 3.69 (SD) minutes and in arm B was 32.23 ± 4.59 (SD) minutes (p < 0.001). Follow-up at the 1st and 7th POD showed significant discomfort in arm B (mean ranks 41.82 and 40.62) compared to arm A (mean ranks 19.18 and 20.38), respectively (p < 0.001). At 1st POD, only 3 (10%) graft retractions in arm A. Within 6 months of follow-up, all grafts were stable; 1 (3.3%) recurrence and 1 (3.3%) granuloma in arm B only.

Conclusion: In primary pterygium surgery, autologous blood showed excellent postoperative results with no recurrence and reduced surgical time. So, it seems to be an effective surgical means to treat primary pterygium.