Clinical study of efficacy of amniotic membrane grafting in the management of pterygium

Background: Pterygium is a triangular fibrovascular, subepithelial in growth of degenerative bulbar conjunctival tissue encroaching over the limbus onto the cornea located commonly horizontally in inter palpebral fissure on either nasal or temporal side of cornea or sometimes on both sides. Aim and objectives: To study the efficacy of amniotic membrane grafting in prevention of recurrence, to know the complications associated with amniotic membrane grafting, and to assess the visual prognosis. Materials and methods: This was a prospective observational study for a period of 1 year, a total of 70 pterygia of 70 patients were studied, and who attended the outpatient department. Each patient was totally evaluated by complete history, total ocular and systemic examination with necessary investigations. They were diagnosed as various grades of pterygia, depending on the extent of cornea involved. Results: This study group consisted of 70 patients; the patients were followed up for 6 months. Out of which 24 (34.28%) were male patients and 46 (65.71%) were female patients. Highest prevalence of pterygium was seen in age group of 31-40 years. 20 eyes (28.57%), followed by 41-50 years 18 eyes (25.57%), followed by 20-30 years 17 eyes (24.28%), followed by 51-60 years 10 eyes and 61 years 5 eyes (7.14%). Commonest presenting symptom was foreign body sensation, redness, watering followed by fleshy growth and defective vision. There were no cases with complaints of diplopia. Out of 70 operated cases, 39 (55.71%) were right eye and 31 (44.28%) were left eye. Out of 70 patients, 68 cases had only nasal pterygium (97.14%), 1 case had double pterygia (1.42%), 1 case (1.42%) had only temporal pterygium. During post-operative follow up, 1 case of granuloma, 1 case graft retraction with foreign body sensation, 2 cases of loose suture with graft dislodgement were noticed. During the follow-up period of this study, pterygium recurred in 3 patients. The average duration of recurrence was 2.3 months. The average age of the patient with recurrence was 30 years. More recurrence in GII and GIII pterygia were noticed in this study. Out of 70 patients, best corrected visual acuity remained stable in 21 cases (30%), improved in 49 cases (70%). The post-operative cosmesis was graded as good in 58 (87%) cases, as fair in 7 (10%) cases and as poor in 5 (2.85%) cases. Conclusion: AMT is a safe and effective procedure in the management of pterygium. AMT is a better method with regard to visual outcome, improvement of astigmatism, incidence of recurrence and complications.