A comparative study to evaluate the clinical outcome between dry amniotic membrane and conjunctival limbal autograft after excision of primary pterygium

Objectives: To assess the efficacy and safety of dry amniotic membrane graft after pterygium excision in primary pterygium and compare the clinical outcome with conjunctival limbal autograft. Materials and Methods: This randomized clinical trial was done on 60 patients with primary pterygium attending ophthalmology outpatient department. Patients who fulfil inclusion and exclusion criteria were randomized to receive conjunctival limbal autograft (CLAG) or dry amniotic membrane graft (dry AMG) after surgical excision. Intraoperatively, the clinical outcomes assessed were button hole and graft tear. Post operatively, we evaluated graft loss, graft edema and recurrence after surgery on postoperative day one, 1 week, 1 month and 3rd month. The standard procedure was followed for pterygium excision by single surgeon and one of the above graft was used to cover the bare sclera and sutured. Results: The patient’s age ranged from 32-71 years (mean age, 47.7 years). 39 males and 21 females were included in the study. Majority of pterygium patients were elderly males (51.28%) and outdoor working population (71.6%). The intra operative complications noted were button hole (3.3%) and graft tear (2.85%). Immediate post operative complications were graft oedema (26.6%) and graft loss (10.0%). Recurrence rate was (6.66%) in CLAG and (16.66%) in dry AMG group. Conclusion: Dry amniotic membrane graft is beneficial, safe and has few complications. It can be used as an adjunctive therapy in patients with conjunctival scarring, double headed pterygium and glaucoma patients requiring filtering surgery. Keywords: Conjunctival limbal autograft, Dry amniotic membrane graft, Pterygium