EXTENDED REPORT Cut and paste: a no suture, small incision approach to pterygium surgery

Aim: Evaluation of the benefits of a new technique for pterygium surgery with respect to postoperative pain and surgery time. Methods: A prospective randomised clinical trial was carried out in 43 patients. 43 eyes were operated for primary nasal pterygium. Autologous conjunctival graft taken at the superotemporal limbus was used to cover the sclera after pterygium excision. After randomisation, in 20 patients the transplant was attached to the sclera with a fibrin tissue adhesive (Tisseel Duo Quick) and in 23 patients with absorbable sutures (7–0 Vicryl Rapid). The Mann-Whitney test was used as statistical analysis. Postoperative pain was graded according to the visual analogue scale (VAS) twice daily during the first week after surgery. Surgery time was noted from the first incision until the lid speculum was removed. Results: The average pain was significantly lower when glue had been used, p,0.05. Average surgery time was 9.7 minutes (range 6–13) for glue and 18.5 minutes (range 12–30) for sutures, p,0.001. No complications occurred. Conclusion: Using glue instead of sutures when attaching the conjunctival transplant in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.