Cautery fixation technique minimizes risk of graft dislocation in pterygium surgery

Cornea. 2011;30(2):194-195.

Cautery fixation of an amniotic membrane transplant showed potential efficacy and economy in pterygium surgery, a study found.

The technique was found to be a suitable alternative to the combined use of sutures and fibrin glue, which may increase surgical time, increase the risk of infection and yield poor cosmetic results.

"This technique provides a quick, inexpensive, and effective method of [amniotic membrane transplant] fixation for use in pterygium surgery while avoiding issues associated with fibrin glue, but further study is needed to determine the effect on recurrence rates and provide a comparison with other described fixation techniques," the study authors said.

The study included 17 patients diagnosed with pterygia; 12 patients had primary pterygia and five patients had recurrent pterygia. Average follow-up was 7.12 months.

The amniotic membrane transplant was oversized 3 mm to 4 mm, or 1.5 mm to 2 mm on each side. Cautery power was introduced at a low level and increased until suitable graft reaction occurred. Pressure was applied with forceps to prevent the eraser tip from lifting the graft after fixation to the episclera.

Average surgical time was 22.65 minutes, comparable to that of techniques using extensive Tenon's layer dissection and fibrin glue alone.

Study results showed no amniotic membrane transplant malpositioning, dislocation or loss, and no granuloma formation. No recurrences of pterygia were reported at 11.12 months' average follow-up, the authors reported.