Should we be doing suture-less auto-grafts on pterygium surgery in a

developing world setting?

The advantage of this method is that it is quick as sutures are not required and it potentially has fewer

inflammatory mediators flowing to the site of the wound, post- surgery, suggesting a speedier recovery

may be possible.

The disadvantage is that the auto-grafts are easy to rub off or displace as seen here in a case this year

where a patient rubbed his eye two days after surgery.

The use of a bandage contact lens would reduce the number of displaced suture-less grafts. However

this may not be ideal in a rural villages unless you have someone who can remove the contact lens after

a few weeks.

When done well the suture less graft can look very good as in this example ten days after surgery in

2011(on left) with follow up picture from 2015 (on the right).

Four years on and the scar is still visible but the overall result is still good. What do you think?? Which method has the best long term results for patients in remote villages with no access to regular eye care?

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