Intra-operative Management of Torn Grafts and Small Grafts in Eyes Undergoing Pterygium Excision with Conjunctival Autografting

Abstract

AIM-To demonstrate intraoperative techniques in managing torn grafts and small grafts in pterygium excision with conjunctival autografting (CAG). METHODS-Fifteen eyes that had graft tear during nasal pterygium excision with CAG and six eyes with small inadequately sized grafts during double head pterygium excision with split conjunctival grafting were included in the study. The graft tears occurred during dissection and the torn grafts were placed as separate pieces to cover the defect completely and in cases of double head pterygia with small graft on one side, a part of the graft from the other side (nasal or temporal) was used to cover the remaining defect. All the grafts were secured using tissue adhesives. RESULTS-Clinical outcomes in all cases were good. The recurrence rate was found to be 4.6%, with recurrence seen in one eye at four months post operatively. Other complications like graft edema and graft necrosis were also similar to those reported in previous literature for routine single head and double head pterygium surgeries. CONCLUSION- In complications like graft tear or small grafts, it is important to utilize the torn graft and part of the other graft in cases of split grafts and carefully resurface the bare area with proper orientation to give an adequate cover, in order to minimize recurrence.