To study the management of primary pterygium by surgical excision with conjunctival autograft with limbal stem cells in a tertiary care hospital in hilly area of North India

Aim: The aim is to study the management of primary pterygium by surgical excision with sutureless conjunctival autograft with limbal stem cells. Materials and Methods: Patients with advanced pterygium were recruited from eye outpatient department (OPD) of rural tertiary care hospital of central India from January 2016 to October 2016. Informed written consent was taken before enrollment. The total 54 eyes (of 42 patients) were operated for pterygium with conjunctival autograft with limbal stem cells. Graft margins were buried around 0.25mm below the host conjunctiva. Results: The mean age of the patients was 48.71 ± 12.87 years. The male patient were 30 (38 eyes, 71.43%) and females were 12 (16 eyes, 28.57%). The most common age group of presentation was 40 to 60 years (28 patients, 66.67%), followed by 61 to 80 years (10 patients, 23.81 %) and lastly age less than 40 years (4patients, all female, 9.52%). At the follow up of 6 months 1 eyes showed recurrence and at 1 year 1 eyes showed recurrence. The recurrence was 3.70 percentage at 1 year of follow up. The recurrent pterygium were reoperated with pterygium excision with mitomycin C (0.02). The patients with recurrence have completed 2 months follow up without any signs of recurrence. In 28 patients (51.85%) showed improvement in visual acuity (2 or more lines) on Snellen chart. Conclusion: Management of primary pterygium by surgical excision with sutureless conjunctival autograft with limbal stem cells is a effective surgical technique in preventing recurrence of pterygium and good cosmetic appearance of eyes after pterygium surgery. The author recommends use of Mitomycin C (MMC) or 5 Fluorouracil (FU) only in selected cases pterygium like extensively infiltrating pterygium or recurrent pterygium.