Abstract:
BACKGROUND
Pterygium is a common ocular surface disorder. It is a slow growing, wing shaped
proliferation of fibrovascular tissue, araising from the subconjunctival tissue and encroaching
over the cornea.[1] It is more common on the nasal side. It causes foreign body sensation,
redness, visual impairment, and diplopia.
Surgical excision is the treatment of choice for pterygium. Conjunctival autografting has been
used frequently following pterygium excision. Recurrence is one of the most common
complication of pterygium. Several methods like amniotic membrane implantation, use of
adjuvants such as beta- irradiation, thiotepa, 5-Fluorouracil, mitomycin C were used for the
treatment of pterygium surgery. Ethanol is an alternate adjuvant which can be used in the
pterygium excision. Ethanol causes rapid denaturation of proteins, including cytokines,
enzymes, and growth factors involved in pterygium formation and recurrence after excision.
Application of ethanol at a concentration 20% less than the 60s on the cornea appears to be
safe. It helps to identify the plane between the pterygium and underlying cornea during
surgery. Only a few studies have been conducted regarding the use of ethanol in pterygium
excision.
AIM AND OBJECTIVE OF THE STUDY
To study the efficacy and safety of 20% ethanol as an adjuvant in pterygium excision
with conjunctival autograft implantation and to evaluate the surgical outcomes of using 20%
ethanol as an adjuvant in pterygium surgery.
METHODS
This is a prospective interventional study conducted among 30 patients with primary
pterygium August 2022 to December 2023. Patient were evaluated preoperatively for anterior
segment, posterior segment, visual acuity and corneal astigmatism Pterygium is excised using
20% ethanol as an adjuvant and conjunctival autograft was placed over bare sclera withoutsuture. Patients were evaluated postoperatively on day 1, day 8, day 30 and day 90 for
condition of graft, visual acuity, corneal astigmatism, and associated complications.
RESULT
After 3 months of follow up, the mean visual acuity improved to Logmar 0.46 ±0.35
(p=0.001) which was statistically significant and corneal astigmatism improved from 3.36 ±
2.87 to 0.87±0.57 (p=0.001). No recurrence noted within 3 months of follow up.
CONCLUSION
This study has shown that using 20% ethanol as an adjuvant for pterygium excision helps in
easy and clean dissection of pterygium head from underlying cornea and the pterygium
induced corneal astigmatism has significantly reduced which was associated with
improvement in visual acuity.
