Background: There are several surgical techniques for pterygium excision, with variable reported recurrence rates. This study aimed to identify, 1) The recurrence rate of sutureless pterygium excision with conjunctival autograft secured with Tisseel glue (Baxter International); 2) Whether recurrence rate was dependent on the grade of the operating surgeon; 3) The benefit of histopathological analysis of surgically excised pterygium tissue samples.

Methods: All pterygia cases performed within the corneal service at Bristol Eye hospital under a single supervising consultant, during the study period January 2012 to October 2018, were retrospectively reviewed. A clinically significant recurrence was defined as a pterygium that required further surgical excision during the study period. The surgical technique involved pterygium excision with the use of conjunctival autograft secured with Tisseel glue (Baxter International).

Results: 134 cases from 118 patients, were performed during the study period. The overall recurrence rate was 1.5% (2/132). The two recurrent cases had their initial procedure performed by a surgeon of non-consultant grade. Histopathological analysis of 101 of the 103 cases sent for histology, confirmed the features of the tissue to be consistent with the diagnosis of a pterygium.

Conclusions: This study supports the use of a conjunctival autograft using Tisseel glue (Baxter International) at the time of pterygium excision surgery in providing low recurrence rates with minimal complications and increased surgical efficiency. Recurrence may be dependent on the grade of operating surgeon. In the UK NHS setting of this study, histological analysis provided little additional benefit for this group of patients.

Cystoid macular edema, Uveitis, Anti-TNF therapy, Tocilizumab