Dehydrated human-amnioticmembrane allograft versus conjunctival autograft after pterygium excision

Abstract

Objective: To compare the efficacy of dehydrated human-amniotic-membrane allograft with conjunctival autograft attached with fibrin glue following pterygium excision.

Methods: Forty-two patients undergoing excision of primary pterygium were enrolled in this prospective, randomized, interventional, controlled trial. After excision of pterygium, a superior bulbar conjunctival autograft was harvested and transferred onto bare sclera in 21 eyes, and dehydrated human-amniotic-membrane allograft (AmbioDry) in 21 eyes. Fibrin glue (Beriplast P) was used to attach the grafts in both groups. The patients were followed up for 3 months.

Results: All grafts in both groups were successfully attached. One patient in the conjunctival autograft group experienced graft dehiscence. Mean surgery time, postoperative pain, foreign-body sensation, and discomfort were not statistically different (p = 0.16, p = 0.07, p = 0.82, and p = 0.31 respectively). No recurrence was noted within the observation period. At day 1 postoperatively, mean tearingseverity scores of patients that received dehydrated amniotic-membrane allograft were statistically lower than those that received conjunctival autograft (p = 0.024). Cosmetic-grading results were statistically higher in the conjunctival autograft group at 3 months postoperatively (p = 0.003).

Conclusion: Dehydrated human-amniotic-membrane allograft attached with fibrin glue and anchored with nylon sutures is a safe and effective adjunct after excision of primary pterygium. It is comparable to conjunctival autograft in preventing early recurrence and can be considered as a primary grafting method after primary pterygium excision. However, conjunctival autograft has better cosmetic results than amniotic-membrane allograft.