Tailored corneo-conjunctival autografting in primary and secondary pterygium surgery.

Abstract

To describe the outcomes of a novel technique for pterygium removal: tailored corneo-conjunctival autograft, which offers the advantages of better postoperative cosmetic outcomes and recurrence prevention. This retrospective interventional noncomparative study included 420 eyes in 370 patients (ages 25-60 years) (127 women, 243 men). We divided the patients into 2 groups. The first group included 348 primary pterygium; the second group included 72 recurrent pterygium. All underwent the same type of corneo-conjunctival autograft surgery from April 2009 to March 2014. The average follow-up period was 12 months. The main outcome measures were to assess pain after surgery, conjunctival healing, cosmetic appearance, and pterygium recurrence at the end of follow-up. In both groups, the graft donor site healed promptly without excessive scarring. No patient complained of pain during first week after surgery, except for mild discomfort. No major complications were observed such as infection or graft necrosis. In the first group, 2 patients had graft retraction towards the nasal side and were successfully managed conservatively. One patient had Tenon granuloma, which was removed surgically. Recurrence during the follow-up period was seen in one patient (0.2%). In the second group, no recurrent pterygium cases were observed. The proposed type of corneo-conjunctival autograft offers the advantage of better postoperative cosmetic outcomes. This new technique is effective for surgical management of both primary and recurrent pterygium and preventing its recurrences.