Suture-less auto-grafts for pterygium surgery may have advantages in developing areas as it is quicker than using sutures and allows for faster recovery. However, there is a risk of the grafts becoming displaced if not properly secured. Using a bandage contact lens could reduce displacement but may not be practical in remote villages without follow-up lens removal. While suture-less grafts can look good initially, the scarring and long term results are uncertain compared to using sutures. For remote populations with limited eye care access, sutures may provide better long term results despite being more complex and time-consuming.

1. Should we be doing suture-less auto-grafts on pterygium surgery in a
developing world setting?
The advantage of this method is that it is quick as sutures are not required and it potentially has fewer
inflammatory mediators flowing to the site of the wound, post- surgery, suggesting a speedier recovery
may be possible.
The disadvantage is that the auto-grafts are easy to rub off or displace as seen here in a case this year
where a patient rubbed his eye two days after surgery.
The use of a bandage contact lens would reduce the number of displaced suture-less grafts. However
this may not be ideal in a rural villages unless you have someone who can remove the contact lens after
a few weeks.
When done well the suture less graft can look very good as in this example ten days after surgery in
2011(on left) with follow up picture from 2015 (on the right).
Four years on and the scar is still visible but the overall result is still good.
What do you think?? Which method has the best long term results for
patients in remote villages with no access to regular eye care?
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