Outcome of Pterygium surgery with conjunctival autologous graft using suture and tissue glue at the tertiary eye center, Thimphu, Bhutan

Introduction: Pterygium is a degenerative condition of the conjunctiva characterized by fibro vascular growth of tissue onto the cornea, often necessitating surgical treatment. Currently the conjunctival autograft technique using either suture or fibrin glue is the preferred method of treatment. The aim of the study was to evaluate the outcome of Pterygium surgery using sutures and glue to fix the graft. Methods: This observational study was carried out at the tertiary eye hospital, involving fifty-one patients (51 eyes) with primary Pterygium who underwent Pterygium surgery using either suture (19 eyes) or fibrin glue(32 eyes). The outcome measures were operative time, post-operative symptoms (pain, photophobia, foreign body sensation), and graft complications (displaced, edema, hemorrhage). Patients were followed up on day1, day 7, and day 28 after the surgery as per the standard protocol. Results: The study consisted of 17 males and 34 females, with mean ages of 51.95 (SD 9.82) in the suture group and 51.75 (SD 5.77) in the fibrin glue group. In the suture group, mean operation time was 14.16 (SD 2.71) minutes, and in the fibrin glue group, it was 13.72 (SD 4.54) minutes. With regard to the post- operative symptoms, the intensity of foreign body sensation was found to be higher in the suture group on day 1 and day 7 (p<0.003 and p<0.001, respectively). However the foreign body sensation was not observed in both groups on day 28. There was no significant difference in symptoms like Pain and photophobia. Notably, no graft complications were observed in either group on day 28. All patients completed the required follow ups. Conclusions: The use of fibrin glue in Pterygium surgery with conjunctival autografts relatively reduces surgery time and decreases early post-operative foreign body sensation thus improving early post-operative patient comfort compared to sutures.