Results of Sutureless Autograft Transplantation in Primary Pterygium Surgery Authors: Leon-Cabello MJ, MD, PhD Casal-Valino M, MD Garcia-Hinojosa J, MD,

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Results of Sutureless Autograft Transplantation in Primary Pterygium Surgery Authors: Leon-Cabello MJ, MD, PhD Casal-Valino M, MD Garcia-Hinojosa J, MD, PhD. The authors of this poster have reveived travel expense reimbursement from Company Bausch &Lomb and Company Pfizer.

Introduction - Purpose The prevalence of pterygium varies from 1.2% (in Caucasian populations and at a higher latitude) up to 30% (in tropical latitude, near the Equator).The key factor seems to be the induced damaged to the limbal stem-cells by more aggressive action of ultraviolet solar rays. (1) (2) The considerable increase in immigration from Latin America to Spain (with Ecuadorian population representing the largest minoriy) has had an effect on our daily clinical practise. The purpose of the study is to assess short and long term success and complications after glued conjunctival autograft transplantation in primary pterygium surgery as well as its relation to ethnicity.

Methods Retrospective study of 100 consecutive cases of primary pterygium surgery. A superior conjunctival autograft was harvested and attached onto bare sclera with a fibrin glue (3) after pterygium excision using topical plus subconjunctival anesthesia. In case of double-pterygium (nasal and temporal), a larger conjunctival graft was divided into two pieces. The mean follow-up was 136 days up to a maximum of 17 months. It was considered graft failure as an abscence of graft by the fourth week.It was considered recurrence as any growth of conjunctiva into the cornea.

Methods Follow upCases < 1 Month < 3 Months < 6 Months < 9 Months < 12 Months2 > 12 Months12 Double Pterygium

Results ComplicationsCases% Recurrence rate99% Graft Failure55% Inclusion Cysts33% Dellen11% Diplopia11% Pterygium Recurrence Inclusion Cyst

Results All of the recurrence cases were found in Latinos. All of the double-pterygium cases were found in Latinos. There was a statistically significant difference in the pterygium recurrence rate between the Latin American population (9%) and the Caucasian local Spanish population (0%) (p < 0.05). The average time to recurrence was 4.6 months (range, ).

First Day of follow up after Conjunctival Autograft Two months after conjunctival autograft

Results CountryCases% Spain2727% Latin America 7272% Mali11% Total100100% Good Cosmetic Appearance after Conjunctival autograft

Results Nationality *Cases% Ecuador4646% Spain2727% Peru1212% Bolivia1010% Dominican Republic22% Venezuela11% Brazil11% Mali11% Total100100% *Source”: CIBELES: Centro Información Basica Estrategica para Los Entornos Sanitarios

Results Eye- PterygiumCases%Recurrent Cases OD- Simple5555%6 OS- Simple4141%2 OD- Double22%1 OS- Double22%0 Total100100%9 Patient Age by Country NArithmethical Mean Standard Deviation Spain Others

Conclusions Conjunctival Autograft Transplantation provides better results among Caucasian local Spanish population where it seems to be a definitive treatment. Latin American ethnicity is a potencially important risk factor for recurrence of primary pterygium. No major complications have been found.

Bibliography (1) Arriola Villalobos, P. Epidemiología del Pterigium. In: Mª Teresa Iradier Urrutia. Cirugía del Pterigium. Sociedad Española de Oftalmología (2) Kandavel R, Kang JJ, Memarzadeh F et al. Comparison of Pterygium Recurrence Rates in Hispanic and White Patients After Primary Excision and Conjunctival Autograft. Cornea 2010; 29: ). (3) Uy HS, Reyes JMG, Flores JDG et al. Comparison of Fibrin glue and Sutures for Attaching Conjunctival Autograft after Pterygium Excision. Ophthalmology 2005; 112: Acknowledgments To Susana de Juan,MD, for her support with the statistical analysis To Alejandro Aguirre, MD, for his unconditional help. To the administrative team from Infanta Leonor Hospital for their help gathering data.