Elsevier

Ophthalmology

Volume 110, Issue 4, April 2003, Pages 806-810
Ophthalmology

Inferior conjunctival autograft for primary pterygia☆

https://doi.org/10.1016/S0161-6420(02)01970-XGet rights and content

Abstract

Objective

Superior conjunctival graft is commonly used in pterygium surgery, which may adversely affect the outcome of future filtration surgery. We retrospectively studied the success rate of inferior conjunctival autografting for primary pterygia in our unit.

Design

A noncomparative, retrospective, interventional case series.

Participants

Thirty eyes of 27 patients treated between August 1996 and February 2001 with primary pterygia.

Intervention

Excision of pterygium followed by conjunctival autograft harvested from the inferior bulbar conjunctiva. Surgeries were performed by an experienced surgeon (CL) in 23 patients and by trainees in the remaining four cases.

Main outcome measures

Recurrence of the pterygium and complications.

Results

Mean follow-up was 27 months (range, 8–53). Recurrence occurred in one eye (3.3%). This was a white female in her early fifties, with recurrence detected 3 months after the surgery. Conjunctival scarring at the donor site was observed in 11 eyes (36.66%). There was no symblepharon formation. There was no restriction of up gaze. Hemorrhage under the conjunctival graft developed in three eyes, corneal dellen near the limbus developed in four eyes, and epithelial inclusion cysts at the recipient site developed in two eyes.

Conclusions

Inferior conjunctival autografting is an effective technique with a low recurrence rate. This is a useful technique in cases in which it is not possible or desirable to use the superior conjunctiva as a donor source.

Section snippets

Patients and methods

Excision of pterygia, extending at least 2 mm beyond the limbus, followed by inferior conjunctival autograft was performed in 36 eyes of 32 patients between August 1996 and February 2001 at our institution. All patients who needed pterygium removal were treated with inferior conjunctival autograft. The cases were accrued consecutively over the period. Patients with recurrent pterygia and other ocular surface pathologic features were excluded from the study. No patient had undergone any other

Results

Of the 32 operated patients, 27 patients (30 eyes) were reviewed after a mean follow-up period of 27.3 months (range, 8–53 months), and data collected from these patients were analyzed (Table 1). These patients were seen on the first postoperative day, 1 month after the operation, and at the time of final follow-up. Three patients were lost to the final follow-up despite our best efforts to contact them through telephone and mail, and they were excluded from the study. Thirteen patients were

Discussion

Simple excision of pterygium is associated with high recurrence rates of approximately 30% to 70%.2, 3 To reduce recurrence rate, β irradiation or mitomycin C has been used.3, 4 However, serious complications such as severe secondary glaucoma, cataract formation, uveitis, scleromalacia, scleral ulcer, and corneal perforation are associated with these methods of treatment.4, 5 Although a single application of intraoperative mitomycin C is associated with a lower incidence of complication, the

References (25)

  • A. Jap et al.

    Conjunctival rotation autograft for pterygium

    Ophthalmology

    (1999)
  • G. Singh et al.

    Long term follow-up study of mitomycin eye drops as adjunctive treatment for pterygia and its comparison with conjunctival autograft transplantation

    Cornea

    (1990)

    • Cited by (39)

    View all citing articles on Scopus
    ☆

    Manuscript no. 220296

    None of the authors have any financial interest related to this manuscript.

    View full text
    Copyright © 2003 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.