Suture Less and Glue-Free Inferior Limbal Conjunctival Autograft Transplantation in Primary Pterygium Surgery: A Case Series

Introduction: Conjunctival autografting which is the mainstay in the management of pterygium. The conjunctival graft is most commonly harvested superiorly. However, superior bulbar conjunctiva may not be available for harvesting a graft in all cases and it would affect the outcome. This study aims at the efficacy of the inferior bulbar conjunctival grafting without using any suture or glue. Methods: This was a prospective observational study conducted in the Department of Ophthalmology, Pabna Medical College Hospital, Pabna, Bangladesh during the period from January 2019 to December 2020. In our study, we included 100 eyes of 98 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 100 cases were included in this case series. Patient’s age ranged from 18 to 83 years (mean 48.08±12.76 years). Total graft dehiscence occurred in 2 eyes (2%), graft retraction in 10 eyes (10%), and recurrence was seen in 1 eye (1%). At 3 months postoperatively, the gain in uncorrected visual acuity ranged from 2-3 lines in the Snellen chart in 9 eyes, symblepharon does not occur in any patient and no other complication was noted. Conclusion: Our study shows that this simple technique for pterygium surgery may prevent the potential risk of bad outcomes of future filtration surgery and overcome the conditions when superior bulbar conjunctiva may not be available for harvesting a graft.