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First Author: M.Belovari Visnjic CROATIA
Co Author(s): R. Ivekovic I. Krolo R. Tadic O. Zrinscak Z. Mandic
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Aim of this study is to evaluate effectiveness of two surgical techniques for limbal stem cells conjunctival graft fixation: autoblood vs. standard suturing procedure.
University Eye Clinic, University Hospital Center Sestre milosrdnice, Zagreb, Croatia
A comparative study included 82 patients with pterygia whose preoperative growth over cornea was between 2 and 4 mm. Pterygial surface was treated with 20%-ethanol applied for the period of 30 seconds before being excided together with associated conjunctiva. In 48 patients (autoblood group) a thin film of blood clot was formed over the bare area, any active bleeding was stopped by direct tamponade. A Tenon-free conjunctival autograft, including limbal stem cells, was created in superior quadrant. It was placed over the blood film in the bare area and the edges were held with forceps for 5 minutes to give adequate time for graft fixation to occur. In 34 patients ( standard group) traditional suturing technique was used for limbal stem cells conjunctival fixation. Outcome measures included surgical time, postoperative complications, patients subjective satisfaction and rate of recurrence. All patients were examined preoperatively and during follow-up examinations after 1 day, 1 week, 1 , 3 and 6 months.
Surgical time was shorter in autoblood group than the traditional sutured approach, with less postoperative pain, discomfort and better cosmetic results. Limbal stem cells conjunctival autoblood graft fixation is more economic than fibrin glue, with same advantage of less recurrence rate and postoperative fibrosis.
Autoblood graft fixation represents a new challenge for ophthalmic surgeons, and it might be considered as a standard procedure in pterygium surgery.