The aim of this study is to introduce a new surgical technique for the removal of pterygiums that entails the use of bipolar electrocautery to secure the graft, rather than sutures. With this, the objective is to evaluate the benefits of a new technique for pterygium surgery with respect to postoperative patient comfort, surgery time, cost and recurrence rate.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
* Pterygium dissected off, corneal bed burred smooth and autograft harvested as per usual technique. * Conjunctiva undermined at the recipient site. * Relaxing incisions placed at the corners of the recipient site. * Graft is slid into place * Graft / host interface is gently dried with a Qtip * Bipolar cautery is applied after grasping the graft and host conjunctiva gently between cautery forceps. * Power setting: 25. * Duration of cautery: 4 -5 seconds; the tissue should whiten and contract as desiccation and coagulation take place. Some charring may occur. * Counter traction is applied to the conjunctiva as the cautery forceps are gently teased off * Cautery is applied at the 4 apices of the graft then in between these points.
* Pterygium dissected off, corneal bed burred smooth and autograft harvested as per usual technique. * Conjunctiva undermined at the recipient site. * Graft is slid into place The graft is secured to host conjunctiva using 7 interrupted sutures
Queen Elizabeth Hospital
Bridgetown, Barbados
Patient Discomfort
Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep.
Time frame: Day 1
Patient Discomfort
Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep.
Time frame: Week 1
Patient Discomfort
Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep.
Time frame: Week 2
Patient Discomfort
Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep.
Time frame: Week 3
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Patient Discomfort
Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep.
Time frame: Week 7
Patient Discomfort
Grading of patients' symptoms (pain, foreign body sensation, irritation, and epiphora) will be done using a 5-point scale. The scale ranges from 0 to 4: 0 = no symptom at all; 1. = presence of the symptom but easily tolerated; 2. = presence of the symptom causing some discomfort; 3. = presence of the symptom causing discomfort that interferes with usual activity or sleep; 4. = presence of the symptom that completely interferes with usual activity or sleep.
Time frame: 3 months
Operating time
Analysis. start time of operation, start time of conjunctival graft attachment and end time of operation will be recorded.
Time frame: day 1