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Purpose: To compare the use of polyglactin sutures versus nylon sutures for conjunctival autograft suturing in pterygium surgery. Methods: A prospective, randomized, controlled, clinical trial was conducted, in which 32 eyes of 32 patients with primary nasal pterygium were randomized to undergo pterygium surgery with the use of nylon sutures or polyglactin sutures for conjunctival autograft suturing. Patients were followed up for 3 months. Outcome measures included postoperative discomfort according to a visual analogue scale (VAS), graft hyperaemia, graft oedema and tarsal conjunctival papillary reaction. Results: There was no significant difference in the postoperative discomfort as assessed by VAS in both groups at all follow-up visits. Patients who had polyglactin sutures for suturing conjunctival autograft were noted to have more tarsal conjunctival papillary reaction at day 1 (p = 0.01) and more graft hyperaemia at week 1 (p = 0.019) after the operation. At 4 weeks postoperatively, significantly more nylon sutures remained on the autograft (p = 0.021), some of which were buried and could not be removed. Conclusions: Both polyglactin and nylon are effective suture materials for autograft suturing in pterygium surgery and cause comparable postoperative discomfort. Polyglactin sutures resulted in slightly more conjunctival reaction in the early postoperative period compared with nylon sutures. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to evaluate the variability of using a visual analogue scale (VAS) and to assess the feasibility of a priority-setting scoring system for prioritizing elective cataract surgery. Consecutive cases listed for cataract surgery were prospectively recruited. Ophthalmologists listed patients to undergo early or normal surgery and were asked to rate the urgency of surgery using a VAS. Patients were then reassessed and a cataract surgery prioritization (CSP) score was calculated based on the New Zealand priority criteria for cataract surgery. Correlation coefficients between VAS and CSP scores were calculated to determine the variability among ophthalmologists in using the VAS in prioritizing surgery. Further analyses were performed to assess the potential impact of implementing the CSP system. A total of 326 patients were recruited. There was a positive correlation between VAS and CSP scores (Spearmanρ= 0.407, P < 0.001). A high degree of variation among ophthalmologists in the use of VAS was found. Patients with poor binocular vision were not listed as early, whereas patients with poor vision in the eye listed for cataract surgery but good vision in the fellow eye were more likely to be prioritized to have early operation. These findings suggest that patients with severe impairment in binocular visual function were not adequately accounted for during cataract surgery listing. The use of a VAS for prioritizing cataract surgery may be suboptimal due to high subjectivity. Adoption of an objective criteria-validated priority-setting scoring system may allow better stratification of patients to ensure better service provision. [ABSTRACT FROM AUTHOR]

A response by Victoria W. Y. Wong to a letter to the editor about her article "Polyglactin sutures versus nylon sutures for suturing of conjunctival autograft in pterygium surgery: a randomized controlled trial" in the 2007 issue is presented.