CORNEAL TOPOGRAPHIC CHANGES AFTER PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFTING USING SUTURES VERSUS FIBRIN GLUE: A COMPARATIVE STUDY

Aim: To compare the corneal topographic changes after pterygium excision with conjunctivalautografting using sutures versus fibrin glue. Materials and Methods:A prospective study was conducted on 100 eyes of 100 patients visiting the outpatient Department of Ophthalmology,Government Medical College Srinagar over a period of two years. Patients were randomly allocated in two groups (Group S and Group FG) and underwent complete eye examination along with preoperative corneal topography where corneal astigmatism at central 3mm and total mean refractive power of cornea were noted.50 patients underwent pterygium excision with conjunctivalautografting using 10-0 nylon sutures (Group S) and other 50 underwent same procedure using fibrin glue (Group FG). Corneal topography was again repeated postoperatively in both groups at 2nd week, 1st month, 3rd month and 6th month of follow up and results were noted. Results:The mean age of study patients in suture group was41.7±8.64 years and in fibrin glue group was39.5±9.58 years. The mean corneal astigmatism at central 3mm significantly decreased from 1.95D preoperatively to 0.61D at postoperative 6thmonth following pterygium excision (p-value 0.003) in suture group. The mean preoperative corneal astigmatism in patients in fibrin glue group also decreased from 2.03D preoperatively to 0.62D at 6thmonth postoperative follow up(p value<0.001).The total mean refractive power of cornea increased significantly from 43.17D preoperatively to 44.59 D postoperatively at 6th month of follow up (p value <0.001) in suture group and in fibrin glue group it significantly increased from 43.23D preoperatively to 44.69D at 6thmonth of postoperative follow up (p value < 0.001).However no significant difference was seen in the postoperative corneal astigmatism at central 3mm or total mean refractive power of cornea between the two groups at any follow up. Conclusion:Pterygiumexcision with conjunctiva autografting causes reversal of corneal topographic changes induced by pterygium irrespective of whether fibrin glue or sutures are used for autografting.