Comparison between Limbal Autograft Transplantation and Subconjunctival Bevacizumab Injection in Lowering Recurrence of Primary Pterygium

Abstract Backogund: Pterygium is a common ocular surface dis-order with a wing shaped fibrovascular overgrowth of bulbar conjunctiva onto the cornea and it is often triangular in shape and consists of a head, i.e., the part which rests on the cornea, a neck, and a body. It is a common conjunctival degenerative condition, which is characterized by elastotic degeneration of collagen and fibrovascular proliferation. Pterygium occurs as a result of breakdown of the corneoscleral limbal barrier results in subsequent conjunctivalization of the cornea, as the scattered light might follow alternative optical paths when entering the eye, thus hitting limbal stem cells from their inner surface. Aim of Study: The aim of the current study was to compare the recurrence rate of limbal auto graft transplantation versus single intraoperative subconjunctival Bevacizumab injection after surgical removal of the primary Pterygium. Patients and Methods: This was a prospective cohort study, the study was conducted on 20 eyes (10 Patients) with primary pterygium patients, attended the outpatient clinic of the Ophthalmology Department at Al-Azhar University Hos-pital (Cairo), during period from January 2021 to July 2021. Patients were being divided into equal 2 groups: Group 1: Pterygium was excised then limbalautograft was placed (10 eyes), and Group 2: Pterygium was excised followed by subconjunctival injection of bevacizumab (10 eyes). Results: Hundered percent inlimbal group were not recur-rent, and twenty percent of the conjunctival injection group was recurrent, and there was non-statistical significant differ-ence between two groups as regard recurrence. Ninty percent in group A were +ve as regard improvement in visual acuity, and eighty percente of the participants in the group B had +ve improvement in visual acuity, and there was non-statistical significant difference between two groups as regard visual acuity improvement. Seventy percent of cases in group A had no congestion while all cases in group B had no congestion, and there was no statistical significant difference between two groups as regard congestion, while as regard ischemia, we found that all cases in group A had no ischemia while fourty percente in group B develop postoperative ischemia, and there was no statistical significant difference between two groups as regard ischemia. Follow-up period/months in group A was with a mean ±  SD of 6.25±0.26 months, and in group B, it was with a mean ±  SD of 6.25±0.26 months, and there was no statistical significant difference between two groups as regard follow-up period. Conclusion: There was no doubt that limbal auto graft was a better technique in lowering the primary pterygium recurrence than single dose intra operative bevacizumab injection with no significant difference in intra and post-operative complications.