Conventional Pterygium Excision with Conjunctival–Limbal Autograft Compared with Supra-Tenon Excision of Pterygium Along with Small Limbal Autograft

Abstract

ABSTRACT Context: New pterygium surgery methods have been developed over the years because recurrence is high (30–70%) after simple excision. Aims: To compare the surgical time, ocular discomfort score, and recurrence rate in conventional pterygium surgery, where excision of pterygium and Tenon’s capsule is performed and the area is covered using conjunctival–limbal autograft (CLAU) with supra-Tenon excision of pterygium (STEP) along with small limbal autograft in patients with primary pterygium. Settings and Design: A Prospective comparative study was conducted at a rural medical college–hospital from November 1, 2017, to October 31, 2019, among 110 participants after ethical approval from Institutional Ethics Committee. Materials and Methods: All participants had primary pterygium of grades I and II depending on corneal encroachment and Tan’s stages T1 and T2 morphologically. Fifty-five underwent conventional surgery with CLAU (group A), and STEP with small limbal autograft (group B) was performed in the remaining fifty-five. The follow-up period was one year. The ocular problem, comfort of subject, recurrence, or other complications were documented, and statistical analysis was carried out with Statistical Package for the Social Sciences (SPSS) software version 21. Results: The mean surgical time was significantly less in group B (38.79 vs. 42.04 minutes) (Z = 11.38, P = 0.001 with confidence interval 10.81–13.38) and ocular discomfort score (ODS) was lower in group B as compared with group A (P < 0.05). Group B had two eyes with recurrence, though not statistically significant (P = 0.49). Conclusion: STEP with small limbal autograft is worth consideration for primary pterygium management.