Abstract
Aims and objectives: To evaluate the postoperative symptomatic comfort, visual changes,complication and rate of recurrence in free conjunctival autograft and rotational flap technique inprimary pterygium surgery. Materials & Methods: This prospective study was conducted in 60 eyesof 60 patients, presented with primary progressive nasal pterygium larger than 1mm causingsymptomatic discomfort, astigmatism and cosmetic disfigurement. Patients were divided into twogroups randomly. In group A, patients with pterygium excision with free conjunctival autograft andgroup B, pterygium excision with rotation flap technique were included. Post-operative day 1symptomatic comfort (symptoms and signs), graft stability, corneal clarity and any complicationwere noted. Visual acuity (VA), auto-refracto keratometer measurements and detailedbiomicroscopic examinations, were performed preoperatively and postoperatively at 1month and 3months. Results: Most of the patients in our study were in the middle age group of 40-49 years(41.6%). Out of 60 patients, 35 were males (58.4%) and 25 were females (41.6%). Patients withoutdoor activities had a higher prevalence of pterygium (78.4%). The incidence of pterygium wasmore in the right eye (60%) than left eye (40%). Of the 60 patients, Grade I, II and III pterygiumwas 20%, 56.7% and 23.3% in group A and 16.7%, 63.3% and 20% in group B respectively. Themean symptomatic score was statistically significantly higher for group A for each factor (P<0.05).In the 3rd month, the overall patient’s satisfaction score was significantly higher in group B(P<0.05). Conclusion: Both surgical techniques were equally effective in terms of visual acuity,astigmatism and recurrence. The patient’s satisfaction score was significantly higher in the rotationflap technique group.
Highlights
Pterygium is a triangular wing-shaped, fibrovascular tissue derived from conjunctiva encroaching the cornea[1],which lead to cosmetic and visual deterioration secondary to induced astigmatism and visual axis involvement
In the 3rd month, the overall patient’s satisfaction score was significantly higher in group B (P
The bare sclera is associated with a rate of recurrence as high as 80%.(5).To reduce the recurrence, Mitomycin C (MMC), amniotic membrane and conjunctival transplantation are used after simple surgical excision. [6,7]
Summary
Pterygium is a triangular wing-shaped, fibrovascular tissue derived from conjunctiva encroaching the cornea[1],which lead to cosmetic and visual deterioration secondary to induced astigmatism and visual axis involvement. Several theories have been associated with etiology, its pathology remains controversial [2]. It is more common in the countries with relatively high exposure to ultraviolet radiation, the hot and dusty climates, and those living in rural areas and some occupational groups like agriculture workers, labourers, drivers, welders and carpenters. There are various surgical techniques for pterygium excision like simple excision, pterygium excision with conjunctival free autograft or rotational flap, having their own sets of advantages and disadvantages. Simple surgical excision (the bare sclera) is a simple and common procedure used to remove a pterygium. The bare sclera is associated with a rate of recurrence as high as 80%.(5).To reduce the recurrence, Mitomycin C (MMC), amniotic membrane and conjunctival transplantation are used after simple surgical excision. The bare sclera is associated with a rate of recurrence as high as 80%.(5).To reduce the recurrence, Mitomycin C (MMC), amniotic membrane and conjunctival transplantation are used after simple surgical excision. [6,7]
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