Pterygium
Conditions
Keywords
Pterygium, Pterygiums, Pterygia, Graft, Autograft, Excision, Surgery, Eye, electrocautery, polyglactin
Brief summary
The aim of this study is to introduce a new surgical technique for the removal of pterygiums that entails the use of bipolar electrocautery to secure the graft, rather than sutures. With this, the objective is to evaluate the benefits of a new technique for pterygium surgery with respect to postoperative patient comfort, surgery time, cost and recurrence rate.
Interventions
PROCEDURECautery
* Pterygium dissected off, corneal bed burred smooth and autograft harvested as per usual technique. * Conjunctiva undermined at the recipient site. * Relaxing incisions placed at the corners of the recipient site. * Graft is slid into place * Graft / host interface is gently dried with a Qtip * Bipolar cautery is applied after grasping the graft and host conjunctiva gently between cautery forceps. * Power setting: 25. * Duration of cautery: 4 -5 seconds; the tissue should whiten and contract as desiccation and coagulation take place. Some charring may occur. * Counter traction is applied to the conjunctiva as the cautery forceps are gently teased off * Cautery is applied at the 4 apices of the graft then in between these points.
PROCEDURESutures
* Pterygium dissected off, corneal bed burred smooth and autograft harvested as per usual technique. * Conjunctiva undermined at the recipient site. * Graft is slid into place The graft is secured to host conjunctiva using 7 interrupted sutures
Sponsors
The University of The West Indies
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with one or more pterygiums over age 18
Exclusion criteria
* Patients with glaucoma
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Discomfort | Day 1 | Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operating time | day 1 | Analysis. start time of operation, start time of conjunctival graft attachment and end time of operation will be recorded. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Operating Cost | day 1 | Cost Benefit Analysis. Total cost of pterygium surgery using sutures for graft attachment versus cost using cautery for graft attachment will be calculated and compared. |
| Recurrence | 1 year | Any regrowth of the pterygium onto the cornea will be considered a recurrence |
Countries
Barbados
Outcome results
None listed