A Comparative Study of Autologous Blood versus Conventional Conjunctival Autograft Surgery for Pterygium

Abstract

Background: Pterygium is a degenerative ocular surface disorder manifesting as fibrovascular overgrowth onto the cornea. While Conjunctival Autografting (CAG) is widely accepted as the gold standard for preventing recurrence, the optimal technique for graft fixation remains a point of contention among ophthalmic surgeons. Conventional suturing is effective but is often associated with longer surgical durations and postoperative patient discomfort.

Objective: The primary objective of this study is to compare the surgical efficiency, postoperative morbidity, complication rates, and recurrence outcomes of using autologous blood (AB) for graft fixation versus the conventional suture technique in a tertiary care setting.

Methods: The Department of Ophthalmology at Darbhanga Medical College in Bihar carried out this retrospective comparison analysis using data from January 2024 to January 2025. We examined 104 eyes (104 individuals) undergoing CAG-assisted primary pterygium excision. Patients were divided into two groups: Group B (n = 52) got fixation using 10-0 nylon sutures, while Group A (n = 52) received graft fixation using autologous blood. Operative time, Visual Analog Scale (VAS) pain levels, postoperative complications (granuloma, retraction, hemorrhage), and recurrence rates during a 6-month follow-up were important outcome markers.

Results: Group A demonstrated a significantly shorter mean operative time (18.4 ± 2.1 minutes) compared to Group B (34.2 ± 3.5 minutes) (p<0.001). Postoperative discomfort was markedly lower in the autologous blood group, particularly on Day 1. Suture-related granulomas were unique to Group B (7.7%), while graft retraction was a minor issue in Group A (3.8%). Recurrence rates were statistically comparable (1.9% in Group A vs. 3.8% in Group B; p>0.05).

Conclusion: Autologous blood fixation serves as a highly effective, time-saving, and economical alternative to suturing. It eliminates suture-related morbidity without compromising graft stability or increasing recurrence rates, suggesting it should be the preferred technique in resource-limited, high-volume surgical settings.