Clinical Outcomes of Sutureless and Glue-Free Conjunctival Autografting Using Autologous Blood Following Primary Pterygium Excision: A Prospective Interventional Study

Abstract

Background: Pterygium is a common degenerative ocular surface disorder characterized by fibrovascular proliferation extending onto the cornea. Surgical excision with conjunctival autografting is the preferred treatment; however, conventional graft fixation using sutures or fibrin glue is associated with postoperative discomfort, increased operative time, and additional cost. The present study evaluated the clinical outcomes of sutureless and glue-free conjunctival autografting using autologous blood as a biological adhesive following primary pterygium excision.

Methods: This prospective interventional study included 36 eyes of patients aged 20–70 years with primary nasal pterygium requiring surgical excision. Following pterygium excision under peribulbar anaesthesia, a conjunctival autograft harvested from the superotemporal conjunctiva was secured over the bare sclera using the patient's own blood without sutures or fibrin glue. Patients were followed at 24 hours, 1 week, 4 weeks, and 10 weeks to assess graft adherence, graft dislodgement, subconjunctival haemorrhage, graft oedema, graft recession, recurrence, and operative outcomes.

Results: The majority of patients were 31–40 years old (27.8%), and 66.7% were males. The mean operative time was 16 ± 1 minutes. Early postoperative complications included subconjunctival haemorrhage in 11.1%, graft oedema in 5.6%, and graft recession in 5.6% of patients, while no graft dislodgement was observed. At 12 weeks, 94.4% of patients achieved complete recovery, and only 5.6% had persistent graft recession. Importantly, no graft failure or recurrence was observed during the follow-up period.

Conclusion: Sutureless and glue-free conjunctival autografting using autologous blood is a safe, effective, economical, and minimally invasive technique for the management of primary pterygium. It provides excellent graft stability, short operative time, minimal postoperative complications, and an absence of recurrence, making it an attractive alternative to sutures and fibrin glue.