Surgical management of pterygium in a rural hospital using bare sclera versus conjunctival autograft technique

摘要

Background: Pterygium is defined as a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over limbus onto the cornea. Commonly seen among farmers, fishermen, stone cutters and welders. Both blue and ultraviolet light have been implicated in its causation. Histologically the true Pterygium shows elastotic degeneration of the subconjunctival connective tissue. Pterygium warrant treatment when they encroach the visual axis, induces significant astigmatism or become cosmetically bothersome. My present study was undertaken to evaluate the efficacy, safety and recurrence rates of conjunctival autograft and bare sclera techniques in treatment of progressive true pterygium in a rural hospital. Methods: The prospective study was done in the Department of Ophthalmology, Adichunchanagiri Institute of Medical Sciences, B.G Nagara, Mandya District, Karnataka, India. The study was conducted for a period of 18 months. About 70 patients who presented with progressive pterygium were included in the study. Results: In our study pterygium recurred in 10 cases (14.28%), among which pterygium recurred in 8 cases (22.85 %) using bare sclera technique and in 2 patients (5.71%) using conjunctival autograft technique, best corrected visual acuity remained stable in 37 cases (52.85 %), improved in 33 cases (47.14 %) and worsened in none (0%) of the cases. Conclusions: Conjunctival autografting is a safe and effective procedure in the management of pterygium. The recurrence rate following limbal conjunctival autografting is significantly lower than that following primary conjunctival closure by bare sclera technique.