Cautery fixation for amniotic membrane transplant in pterygium surgery.

Purpose: To report a technique using cautery fixation of the amniotic membrane transplant in pterygium excision.
Methods: The amniotic membrane transplant is oversized 3-4 mm in both dimensions (1.5-2 mm on each side). The transplant is placed in position, and the excess is tucked subconjunctivally 270 degrees. Limbal fixation sutures using 9-0 Vicryl in a buried fashion are placed, and then, amniotic membrane transplant (AMT) overlying the cornea is excised. Cautery fixation of the AMT in a grid pattern using the eraser tip is performed. The cautery power is started low and titrated up until the appropriate reaction of the graft is noted upon application. Forceps are used for countertraction to prevent the eraser tip from lifting the AMT graft after fixating it to the underlying episclera.
Results: This technique was used on 17 consecutive patients with pterygia (12 primary and 5 recurrent). Average surgical time was 22.65 ± 2.57 minutes. No AMT malposition, dislocation, or loss and no granuloma formation were experienced. Although follow-up up to this point is short (average: 7.12 months, range: 2-18 months), no recurrences have occurred.
Conclusions: This technique provides a quick, inexpensive, and effective method of AMT fixation for use in pterygium surgery.