The Cut-and-paste Method for Primary Pterygium Surgery: Long-term Follow-up

Objective: To evaluate the recurrence rate, reoperation rate and side-effects of a novel technique for pterygium surgery.

Design: Retrospective study.

Participants: The study included 461 eyes of 381 patients operated for primary nasal pterygium by the same surgeon between 1994 and 2003 and followed for 23 +/- 20 months (range 6-112 months).

Methods: Autologous conjunctival grafts harvested at the superotemporal limbus were used to cover the sclera after pterygium excision. Using a retrospective chart review, the outcome after attaching the transplant to the sclera with a fibrin tissue adhesive (n = 325) was compared to the outcome after graft attachment using absorbable sutures (n = 136).

Main Outcome Measures: Recurrence rate, reoperation rate and complications.

Results: The recurrence rate was 5.3% in the glue group and 13.5% in the suture group (p = 0.01). The reoperation rates were 1.2% and 3.3%, respectively (p = 0.31). Complications, such as transient transplant oedema and persistent corneal epithelial defects, occurred equally in both groups.

Conclusion: Using a fibrin tissue adhesive instead of sutures when attaching the conjunctival transplant in primary pterygium surgery results in a significantly lower recurrence rate.