Abstract
Background/Objective:
To compare the risk of recurrence and disease-free time after conjunctival autograft (CAG) or conjunctival-limbal autograft (CLAG) with sutureless (fibrin glue) fixation for pterygium excision.
Subjects/Methods
This is a retrospective cohort study. We reviewed the charts of 312 patients who underwent CAG and CLAG sutureless techniques between 2010 and 2019. Follow-up included visits on the 1st day, at weeks 1, 4, and 3, 6, 9, and 12 months after surgery, and every two years afterwards. The primary outcomes were the overall recurrence rate and average time to recurrence. The secondary outcomes were the rates of postoperative complications and the operation duration. Multivariate logistic regression was performed to verify the potential independent predictors of the study outcomes.
Results
265 patients were included, with a mean follow-up time of 31.5 months (maximum 8 years). The pterygium recurrence rate was significantly lower in the CLAG group at 12 months (3.9% vs. 17.4%, p < 0.001) and at the end of the follow-up (4.6% vs. 18.2%, p < 0.001). Patients with CLAG also had a longer time to recurrence (8.8 vs. 4.8 months, p = 0.012). The complications rate was lower for CLAG (0.6% vs. 10.6%, p < 0.002), while no clinically relevant differences were found in the surgery duration (23.4’ for CLAG vs. 25.2’ for CAG). Multivariate analysis confirmed these bivariate results.
Conclusions
Compared with CAG, CLAG reduced the risk and time to pterygium recurrence. Owing to the comparable surgical time and better safety profile, the CLAG technique can be considered a clinically and cost-effective approach for pterygium management.