Profile of complications in pterygium surgery - A retrospective analysis

PURPOSE: Analysis of complication profile after pterygium excision, in primary and recurrent pterygia. METHODS: Retrospective analysis of all the patients who had undergone pterygium excision in a tertiary center in South India from 2010 to 2018 was analyzed. A total of 2356 eyes in 2028 patients were included in the study. Patients who had undergone conjunctival autografting for primary pterygium, conjunctival limbal autografting for recurrent pterygium, vertical split conjunctival autografting for double head pterygium were included in the study. In all the surgical procedures fibrin glue was used for fixation of the autograft. The follow-up period ranged from 6 months to 75 months, with an average of 17 months. Patients with less than 6 months of follow-up were excluded from the study. RESULTS: The following postoperative complications were noted, Sub-conjunctival hemorrhage in 912 eyes (38.7%), edema of the graft in 522 cases (22.15%), graft loss in 22 cases (0.93%), graft retraction in 692 cases (29.37%) and sliding of the graft was seen in 9 cases (0.38%). Granuloma was seen in 4 cases (0.16%) at the host site and 5 cases (0.21%) at the donor site. Recurrence was seen in 34 patients (1.44%). Other severe complications like corneal melt were seen in only 1 case (0.04%) who was operated on for recurrent pterygium. In comparison between primary and recurrent pterygia; subconjunctival hemorrhage, edema of the graft, graft loss, and recurrence was significantly (P < 0.05%) higher in recurrent pterygia. CONCLUSION: Various complications can occur post pterygium surgery as listed above. Selecting a proper procedure for a particular type of pterygium with a proper graft fixation technique will improve the outcome with minimal complications.