Outcome of Pterygium Excision with Conjunctival Auto graft Using Autologous Blood – A Prospective Clinical Trial

Abstract

Background: Pterygium is a common degenerative fibro vascular growth of conjunctival tissue extending onto the cornea, frequently associated with chronic ultraviolet exposure and ocular surface irritation. Surgical excision remains the definitive treatment, but recurrence and postoperative complications remain significant concerns. Conjunctival auto grafting using autologous blood has emerged as a simple, economical, and suture less technique that may reduce postoperative discomfort and recurrence rates.

Methods: This prospective clinical trial was conducted in the Department of Ophthalmology, GMC Kollam, over a period of 1.5 years. Eighty adult patients with primary pterygium were randomly allocated into two groups with 39 patients in Group 1 and 41 patients in Group 2. Group 1 underwent bare sclera excision alone, while Group 2 underwent pterygium excision with conjunctival autograft fixation using autologous blood. Patients were followed up at 24 hours, 1 week, 2 weeks, 4 weeks, 2 months, 3 months, and 6 months postoperatively. Outcome measures included visual acuity, graft stability, postoperative discomfort, graft-related complications, granuloma formation, and recurrence. Statistical analysis was performed using MS Excel and SPSS software.

Results: Among the 41 eyes treated with conjunctival autograft using autologous blood, one eye showed total graft dislodgement, one eye developed graft displacement, and one patient developed granuloma formation. No major post-operative complications were observed otherwise. In the bare sclera excision group, recurrence was noted in two cases during follow-up. The procedure was found to be simple, cost-effective, and associated with satisfactory cosmetic outcomes and minimal post-operative discomfort.

Conclusion: Conjunctival autografting using autologous blood following pterygium excision is a safe, effective, and economical technique with low recurrence and acceptable complication rates. It avoids suture-related complications and may be considered a preferred alternative for the management of primary pterygium.