Outcomes of autologous blood conjunctival graft for pterygium surgery at Mbarara University and Referral Hospital Eye Centre and Ruharo Eye Centre

Abstract

Background: Pterygium management in its advanced stages needs surgery and conjunctival grafting to minimize recurrences. Traditionally, conjunctival grafts were being sutured. Newer techniques such as attachment of the graft with autologous blood are becoming prevalent and outcomes are comparable to other methods of grafting.
A few autologous blood coagulum grafts had been performed in Mbarara University and Referral Hospital Eye Centre (MURHEC) and the outcomes were not well known.
Objective: The study determined the average duration of surgery using autologous blood conjunctival grafts, stability of the graft and associated discomfort post operatively.
Methods: A case series study with 19 eyes that received sutureless autologous blood coagulum grafts on the bare sclera was conducted. Surgery duration was timed from time of speculum insertion to speculum removal. Patients were assessed on days 1 and 14 for discomfort and graft stability.
Results: Nineteen eyes received autologous blood coagulum grafts following their pterygium excision. The mean age of participants was 37 (20-55) years. The average duration for the surgery was 31 (25-40) minutes. Thirteen (68.4%) eyes had their grafts adherent on all corners on their first post-operative day. By the 14th day post operatively, 94.4% had their grafts well secured. One (5.3%) eye had graft displaced on 3 sides and it was reattached with sutures. Five participants (27.8%) had minimal graft dehiscence nasally which later closed.
Conclusion: Autologous blood coagulum takes a shorter duration, has stable grafts and with minimal postoperative discomfort. The procedure is equally effective in securing the graft however some patients may have medial dehiscence.