Modified Sutureless and Glue-Free Method Versus Conventional Sutures for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Randomized Controlled Trial.

Purpose: To compare the advantages and disadvantages of a modified sutureless and glue-free method with those of conventional sutures for conjunctival autograft fixation in pterygium surgery. Methods: A prospective randomized controlled study was performed on 73 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a limbal conjunctival autograft, which was fixed using a modified sutureless and glue-free method in group 1 (39 eyes) and sutures in group 2 (34 eyes). The main outcome measures were operative time, autograft stability, postoperative discomfort, autograft thickness, pterygium recurrence, and complications. Results: The mean operative time was significantly shorter in group 1 (11.9 +/- 1.3 minutes) than in group 2 (24.3 +/- 6.1 minutes, P < 0.0001). On day 2 postsurgery, the average conjunctival autograft thickness was significantly higher in group 1 (861 +/- 340 mu m) than in group 2 (577 +/- 287 mu m, P = 0.034). Subsequently, conjunctival autograft thickness gradually decreased, with no significant difference between groups after 1 week. There were no significant differences in postoperative discomfort between groups, except for a greater foreign body sensation on day 2 and an itching sensation in 1 week in group 2 compared with group 1. Autograft side displacement occurred in 4 patients (10.3%) in group 1; 2 of these 4 developed a granuloma. There was 1 recurrence (2.9%) in group 2. Conclusions: The modified sutureless and glue-free limbal conjunctival autograft fixation method might be effective and efficient for primary pterygium surgery, with potentially decreased recurrence and postoperative discomfort.