Nasal Pterygium Research Articles

Optical Analysis and Reappraisal of the Peripheral Light Focusing Theory of Nasal Pterygia Formation.

PurposePterygia are much more common nasally than temporally. Ultraviolet (UV) radiation is a major risk factor. Coroneo proposed that the nasal preference is caused by the “peripheral light focusing effect,” (PLF), in which UV at an oblique angle passes through temporal cornea and is concentrated on and damages nasal limbal stem cells. This study evaluates whether the PLF is sufficient to explain the nasal preference.MethodsWhereas Coroneo and colleagues derived the maximum PLF intensity gain (UV concentration factor) as a function of incident angle (i.e., different nasal limbal positions were used for different incident angles) the current analysis derived intensity gain at a fixed position such at the nasal corneo-limbal junction (CLJ). This provided a measure of the total PLF irradiation at this position, which was compared to total direct irradiation of nasal and temporal limbus at the corresponding positions (e.g., CLJs). In Part 1, analysis was performed like that of Coroneo, using horizontally incident UV; in Part 2, the analysis was extended to include incident rays above and below the horizontal.ResultsIn both part 1 and part 2 of the study, the limbal UV irradiation of the nasal limbus from the PLF was not sufficient to explain the strong nasal location preference of pterygia.ConclusionsThe analysis calls into question the PLF explanation of nasal location preference. Other explanations of the nasal preference, and of pterygium pathogenesis, should be considered, such as temporal to nasal tear flow carrying substances such as cytokines to the nasal limbus.

Corneal Reinnervation and Sensitivity Recovery after Pterygium Excision.

Purpose To evaluate changes in corneal sensitivity and subbasal nerve density after pterygium excision. Methods This prospective trial included 22 eyes with nasal primary pterygium and 18 controls. Corneal sensitivity was evaluated using a Cochet–Bonnet esthesiometer in the nasal, superior, temporal, inferior, and center quadrants of the cornea before surgery and 10 days, 1 month, and 3months after surgery. The central cornea was analyzed using in vivo confocal microscopy (IVCM) before surgery and 1 and 3 months after surgery. Subbasal nerve density and other nerve parameters were analyzed using NeuronJ. Nerve tortuosity was evaluated and graded in individual IVCM scans. The tear film break-up time (TBUT) test and Schirmer's test were performed before surgery, as well as 1 and 3 months after surgery. All the same tests were performed in the controls. Results All affected eyes showed a significant increase in corneal sensitivity in the nasal corneal quadrant after surgery when compared with preoperative data (F = 37.3; P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (F = 37.3; P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (F = 37.3; P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (Conclusion Pterygium patients demonstrated deteriorated corneal subbasal nerve fibers when compared with healthy controls in terms of nerve length, nerve trunks, and nerve branches. Therefore, pterygium excision improves corneal sensitivity and increases corneal subbasal nerve density.

Optical coherence tomography angiography for marginal corneal vascular remodelling after pterygium surgery with limbal-conjunctival autograft.

To demonstrate the marginal corneal vascular remodelling using optical coherence tomography angiography (OCTA) after pterygium surgery. Twenty-two eyes of 19 patients (8 males, 11 females; age, 58.68 ± 0.34 years) with primary grade-T3 nasal pterygium were enroled in this study. The eyes underwent excision of the pterygium followed by a free limbal-conjunctival autograft. OCTA was performed in the nasal limbal area before surgery and at 10 days, 1 month, and 3 months after surgery. The scans were analyzed in terms of postoperative vascular remodelling of the autograft and marginal corneal vascular arcades (MCAs). Preoperatively, the pterygium presented as abnormal centripetal vascular growth in OCTA scans. The conjunctival vessel density in the nasal quadrant was 29.26% ± 1.00%, 15.80% ± 0.83%, 19.80% ± 0.88%, and 20.26% ± 0.89% before and 10 days, 1 month, and 3 months, respectively, after surgery (F = 1.55, P < 0.01). The vessel density of MCAs was 28.33% ± 0.88%, 42.09% ± 0.41%, and 42.46% ± 0.31% 10 days, 1 month, and 3 months, respectively, after surgery (F = 188.2, P < 0.01). We describe a new application of OCTA for MCA vasculature imaging. Vascular remodelling of the graft and MCAs appeared at 1 month and continued for 3 months after surgery.

Evaluation of the efficacy of autologous cryoprecipitate for attaching conjunctival autograft after primary pterygium excision

Purpose The aim of this study was to evaluate the long-term safety and efficacy of using autologous cryoprecipitate for attaching conjunctival autograft and to compare the results of such technique with the use of vicryl sutures in patients undergoing primary pterygium excision, in terms of surgical time, postoperative patient comfort, visual acuity, complications, and recurrence rate. Patients and methods This is a prospective, interventional, comparative clinical study. It included 200 patients with primary nasal pterygium for whom surgical excision of the pterygium with conjunctival autograft obtained from the same eye was performed. The patients were divided into two groups: autologous cryoprecipitate was used in 100 patients (glue group) and absorbable sutures (8/0 vicryl sutures) were used in 100 patients (suture group) to attach the free conjunctival graft. The main outcome measures included operative time, postoperative pain, lacrimation, foreign body sensation, recurrence rate, and complications. The follow-up period was 24 months. Results The mean operative time was 20.28±2.73 min in the glue group and 31.04±6.52 min in the suture group, with a statistically significant difference (P Conclusion Using autologous cryoprecipitate for attaching conjunctival autograft in primary pterygium surgery resulted in shorter operative time and less postoperative pain, foreign body sensation, lacrimation, and subconjunctival hemorrhage. In addition, it decreased the recurrence rate. The cryoprecipitate method appeared to be effective, reliable, and safe after long-term follow-up.

Pterygium excision with conjunctival autograft fixed with sutures, glue, or autologous blood.

AIMS AND OBJECTIVES:This retrospective study compared surgical outcome of pterygium excision with conjunctival autograft fixed with sutures, tissue glue or autologous blood in relation to recurrence rate and surgical complications.MATERIALS AND METHODS:Surgical records of 148 patients operated for excision of primary nasal pterygium with conjunctival autograft were reviewed retrospectively for the period between January 2015 and June 2018. Based on surgical technique used to fix the graft, patients were divided into three groups. In Group A, 8 “0” vicryl suture was used to fix the graft in 90 patients. In Group B, fibrin glue was used to fix the graft in 23 patients. In Group C, autologous blood was used to fix the graft in 35 patients. Patients who were operated by single surgeon and had followed up for minimum six months were included in the study.RESULTS:Group A had recurrence in 7 cases (7.78%) whereas; Group B and C had no recurrence. But, in Group C two patients (5.71%) lost their graft. Overall recurrence rate in the study was 4.72%.CONCLUSION:Among the three techniques used in the study, recurrence was seen in the suture group and autologous blood group had loss of graft. The fibrin glue group was free of complications.

Tear Film Instability and Meibomian Gland Dysfunction Correlate with the Pterygium Size and Thickness Pre- and Postexcision in Patients with Pterygium.

Purpose This study aimed to evaluate the effects of excision on dry eye and meibomian gland dysfunction (MGD) in individuals with pterygium, before and after surgery. It also aimed to investigate how these effects correlate with the size and thickness of the pterygium. Subjects and Methods 63 eyes from 63 patients with primary nasal pterygium and 45 eyes from 45 healthy volunteers without ocular pathologies were enrolled in this study. 63 eyes from 63 patients underwent pterygium surgery. ImageJ software was used to calculate the pterygium size based on images of the anterior segments. Anterior segment spectral domain optical coherence tomography (SD-OCT) was performed preoperatively to measure the thickness of the pterygium 1 mm anterior to the nasal scleral spur. The ocular surface disease index (OSDI), Schirmer I Test (SIT), and MGD grade were used to evaluate the eyes, and the eyes were imaged using the noninvasive keratograph average tear film breakup time (NIBUTav), tear meniscus height (TMH), meiboscore, and lipid layer grading tools of the Oculus® Keratograph 5M, preoperatively and at 1, 3, and 6 months postoperatively. Results The OSDI, NIBUTav, lid margin abnormality, meiboscore, and lipid layer grading values differed significantly in the pterygium patients in comparison with the controls (p < 0.01 for all scores). However, the SIT and TMH values were unchanged between the two groups (all p > 0.05). Multivariate regression analysis demonstrated that the NIBUTav, meiboscore, and lipid layer grading score was significantly correlated with the pterygium parameters, such as size and thickness. The postoperative OSDI, NIBUTav, lid margin abnormality, and lipid layer grading values improved significantly (p < 0.05 for all scores). The SIT, TMH, and meiboscore results did not differ significantly between the pre- and postoperative values (p > 0.05). Among the conventional and automated indexes, at 1 month postoperatively, SIT and TMH were significantly correlated with the pterygium parameters, but no correlation was observed at 3 and 6 months postoperatively. The OSDI, NIBUTav, meiboscore, and lipid layer grading values at 1, 3, and 6 months postoperatively were significantly correlated with the pterygium parameters. Conclusion Abnormal tear film and meibomian gland (MG) function improved following pterygium excision in the patients with primary pterygium, which was associated with uncomfortable ocular symptoms. Pterygium parameters, such as size and thickness, correlated with the dry eye and MGD indexes in patients pre- and postoperatively, potentially offering a novel strategy for clinical implementation of pterygium excision surgery.

Sutureless Glueless Conjunctival Autograft for Primary Pterygium Surgery

Background: Pterygium is a fibrovascular growth of an abnormal conjunctival tissue that progressively encroaches the limbus and then onto the cornea invading its superficial layers. It is a common ophthalmic condition seen mostly in dry, dusty areas. Objective: The aim of the current study was to evaluate the sutureless glueless conjunctival autograft for primary pterygium surgery as regard technique, complications and success rate. Patients and methods: This prospective study included a total of 30 patients with primary nasal pterygium, attending at Outpatient Clinic of Ophthalmology Department, Al-Azhar University, Damietta. This study was conducted between March 2017 to March 2018. Results: When comparing post-operative values at the end of third month with the first month we have found no difference in corneal state for all patients. The patient with corneal opacity was as the first month and had no difference in corneal state or BCVA. We detected one patient (3.3%) having recurrent pterygium. Finally when comparing post-operative values at the sixth month with the third month, we have found another patient who was reported with recurrent pterygium. Thus, the recurrence rate was 2 patients (6.7%) among all studied patients and the other values were approximately the same. Conclusion: This study suggests that sutureless glueless conjunctival autograft technique is a safe, simple, easy of performance, has less surgical time and very effective for the management of primary pterygium.

Sutureless Glueless Conjunctival Autograft for Primary Pterygium Surgery

Background: Pterygium is a fibrovascular growth of an abnormal conjunctival tissue that progressively encroaches the limbus and then onto the cornea invading its superficial layers. It is a common ophthalmic condition seen mostly in dry, dusty areas. Objective: The aim of the current study was to evaluate the sutureless glueless conjunctival autograft for primary pterygium surgery as regard technique, complications and success rate. Patients and methods: This prospective study included a total of 30 patients with primary nasal pterygium, attending at Outpatient Clinic of Ophthalmology Department, Al-Azhar University, Damietta. This study was conducted between March 2017 to March 2018. Results: When comparing post-operative values at the end of third month with the first month we have found no difference in corneal state for all patients. The patient with corneal opacity was as the first month and had no difference in corneal state or BCVA. We detected one patient (3.3%) having recurrent pterygium. Finally when comparing post-operative values at the sixth month with the third month, we have found another patient who was reported with recurrent pterygium. Thus, the recurrence rate was 2 patients (6.7%) among all studied patients and the other values were approximately the same. Conclusion: This study suggests that sutureless glueless conjunctival autograft technique is a safe, simple, easy of performance, has less surgical time and very effective for the management of primary pterygium.

Modified Sutureless and Glue-Free Method Versus Conventional Sutures for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Randomized Controlled Trial.

To compare the advantages and disadvantages of a modified sutureless and glue-free method with those of conventional sutures for conjunctival autograft fixation in pterygium surgery. A prospective randomized controlled study was performed on 73 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a limbal conjunctival autograft, which was fixed using a modified sutureless and glue-free method in group 1 (39 eyes) and sutures in group 2 (34 eyes). The main outcome measures were operative time, autograft stability, postoperative discomfort, autograft thickness, pterygium recurrence, and complications. The mean operative time was significantly shorter in group 1 (11.9 ± 1.3 minutes) than in group 2 (24.3 ± 6.1 minutes, P < 0.0001). On day 2 postsurgery, the average conjunctival autograft thickness was significantly higher in group 1 (861 ± 340 μm) than in group 2 (577 ± 287 μm, P = 0.034). Subsequently, conjunctival autograft thickness gradually decreased, with no significant difference between groups after 1 week. There were no significant differences in postoperative discomfort between groups, except for a greater foreign body sensation on day 2 and an itching sensation in 1 week in group 2 compared with group 1. Autograft side displacement occurred in 4 patients (10.3%) in group 1; 2 of these 4 developed a granuloma. There was 1 recurrence (2.9%) in group 2. The modified sutureless and glue-free limbal conjunctival autograft fixation method might be effective and efficient for primary pterygium surgery, with potentially decreased recurrence and postoperative discomfort.

Mini-Simple Limbal Epithelial Transplantation Versus Conjunctival Autograft Fixation With Fibrin Glue After Pterygium Excision: A Randomized Controlled Trial.

To compare the outcomes between mini-simple limbal epithelial transplantation (mini-SLET) and conjunctival autograft (CAG) fixation with fibrin glue after excision of pterygium. Ninety-two eyes with primary nasal pterygium were prospectively randomized into a CAG control arm and a mini-SLET study arm. Follow-up examinations were set at the first and third day, at weeks 1, 2, and 4, and at the third and sixth month after surgery. The primary outcome measure was the recurrence rate at 1, 3, and 6 months after surgery, whereas the secondary outcome measures were the intraoperative time, postoperative symptoms, and other complications. Eighty-two eyes completed the 6-month follow-up interval. Of the 42 eyes that underwent CAG, 4 (9.5%) exhibited recurrences, whereas only 1 of the 40 eyes (2.5%) treated with mini-SLET had recurrence (P = 0.358). The time taken for surgery in the study group (21.4 minutes) was greater as compared to the control group (15.1 minutes) (P < 0.001). The postoperative median symptom (foreign body sensation, lacrimation, pain, and irritation) score in the CAG group was significantly more for all symptoms on day 1 and day 3; however, on day 7, it was significantly more for pain and irritation only. Except dellen formation (1 in each group), both groups exhibited different other complications, although less in the study group. The study group exhibited a positive trend of less recurrence with reduced postoperative symptoms and other complications. More similar studies are required in future to validate the results.

The efficacy of suture-less glue-free amniotic membrane graft in the management of pterygium

Objectives: The definitive management of pterygium is surgery, but recurrence has remained a major challenge. This is to study the efficacy of suture-less glue-free amniotic membrane grafting in the prevention of recurrence and associated complicationsMaterials and Methods: It was a prospective interventional noncomparative study conducted between June 2016 and February 2017. Twenty-one consecutive patients with 21 various grades and types of pterygia were studied. The patients had pterygium excision with adjunctive suture-less dehydrated glue-free amniotic membrane (Bio DO ptix amniotic extracellular matrix by Bio Diogics Cordova, Tennessee, USA) graft.Results: There were 10 (47.2%) males and 11 (52.4%) females with a ratio of 0.9:1. The mean age was 36.3±8.74 years. The mean follow-up period was 14.6±3.09 months. Six (28.6%) of the patients had recurrent pterygia while 15 (71.4%) had primary pterygia. Three (14.3%) cases were stage 2 nasal pterygia, 14 (66.7%) were stage 3 nasal pterygia, 4 (19.0%) were stage 4 nasal pterygia. During post-operative follow up, 3 (14.3%) cases of pterygia reoccurred in three patients, two with recurrent pterygia and one had primary pterygium. There were 5 cases of pyogenic granuloma. Four of the pyogenic granulomas resolved with the of topical 0.1% Dexamethasone while one which did not resolve by the conservative management was surgically excised.Conclusion: The prevalence of pterygium reoccurrence was 14.3%. Suture-less glue free amniotic graft appeared efficacious in the management of pterygium in this study

Pterygium excision with conjunctival advancement technique: A clinical study

Aim: To assess the stability of overlying conjunctiva and recurrence of pterygium following subconjunctival pterygium excision with conjunctival advancement technique. Materials and Methods: A prospective interventional study was done on 16 patients with progressive nasal pterygium. The pterygium was excised, separating it from the overlying conjunctiva. The overlying conjunctiva was secured at limbus with 10-0 nylon sutures. Patients were followed up for a period of 6 months following surgery. Results: Good stability of conjunctiva was seen in all patients. Recurrence was seen in 2 patients and persistence of redness in the excised area in 4 patients. Conclusion: This procedure helps to save the superior conjunctiva for future glaucoma surgery. Less number of sutures reduces the time required for surgery and improves patient comfort factor. Keywords: Conjunctival advancement, Glaucoma surgery, Pterygium, Recurrence, Subconjunctival excision.

Optical coherence tomography angiography of perilimbal vasculature: validation of a standardised imaging algorithm

PurposeTo test the reliability and accuracy of a standardised non-invasive imaging algorithm using optical coherence tomography angiography (OCTA) in detecting and quantifying pharmacologically induced changes in the perilimbal vasculature.MethodsIn this...

A comparative study of post-operative outcomes of pterygium excision with autograft using autologous blood and sutures

Aims: To compare the two modes of treatment in pterygium surgery in terms of postoperative outcomes and duration of surgery. Materials and Methods: Prospective study was conducted from September 2017 to June 2018 at the department of ophthalmology, Narayana medical college and hospital, Nellore. A total number of 40 cases with primary nasal pterygium were selected from outpatient department for surgical intervention. The patients were randomly divided into two groups for pterygium excision with autograft using either autologous blood (20 patients) or sutures (20 patients). After surgical intervention eyes were patched for 24 hours in both groups and two groups were compared for duration of surgery, recurrence, graft edema, graft stability and other complications. Results: In comparison to autologous blood technique granuloma was more in suture group whereas graft edema was more in autologous blood technique after pterygium excision with conjunctival autografting. Conclusion: Fixing of graft in pterygium surgery with autologous blood is a better and cost effective technique when compared with sutures without increasing complications. Keywords: Autologous blood, Conjunctiva. Pterygium excision, Sutures.

A Review of Some Significant Breakthroughs in Textile Sutures for Ophthalmic Surgery

The article reviews some significant trends in textile sutures intended for use in ophthalmic surgery. Comparison has been made with rate and type of suture related complications between 10-0 monofilament nylon (Aurolab Nylon Sutures, double arm, Aurolab) and 10-0 polyglactin 910 sutures (Vicryl, single arm, Aurolab) for pediatric cataract surgery. It is a prospective, comparative study performed in children who underwent surgery for congenital or developmental cataract from March 2013 to February 2016. Patients underwent suturing with either nylon or Vicryl in unilateral cases, but in most bilateral surgeries, one eye received Vicryl sutures while the other eye received nylon. The sutures were compared for their complications and the need for suture removal. Also comparison has been made with regard to the clinical results of using silk versus nylon sutures for conjunctival autograft suturing in pterygium surgery. In this prospective, randomized, controlled, clinical trial 50 eyes from 50 patients with primary nasal pterygium were randomized to undergo pterygium surgery with the use of either nylon sutures or silk sutures for conjunctival autograft suturing. Patients were followed up for 6 months. Main outcome measures included recurrence, postoperative discomfort according to a visual analog scale (VAS), graft hyperemia, and graft edema.

Primary nasal pterygium excision with sutureless and glue-free technique of conjunctival autograft

Aim: To evaluate the efficacy and complication of sutureless and glue-free conjunctival autograft for the management of primary pterygium over a period of one year.&#x0D; Methods: Prospective, interventional, hospital-based study. Twenty-four eyes of 24 patients with primary nasal pterygium were graded, and excision was performed by a single surgeon. To prevent recurrence, a free conjunctival autograft was taken from the superior quadrant from the same eye and the bare sclera was covered without the use of sutures or fibrin glue, allowing natural autologous coagulum of the recipient bed to act as a bioadhesive. The eye was patched for 24 hours. Postoperatively, patients were put on topical eye drops (polymixin 0.5%, neomycin 0.5%, and dexamethasone 1%) four times daily for four weeks, and oral antibiotics and methyl prednisolone 3x4 mg per day for 5 days. Patients were followed up postoperatively on day 1, 1 week, 6 weeks, 6 months, and 12 months. They were examined for haemorrhage, wound gape, graft shrinkage, granuloma, graft dehiscence, recurrence, or any other complication.&#x0D; Results: The mean age of the patients was 56.96 ± 11.51 years (range 35-81 years). There were 18 females (75%) and 6 males (25%). The following complications were noted: granuloma in three eyes (12.5 %), overriding graft onto the cornea in three eyes (4.17%), and recurrence in one eye (4.17%). No other complications were noted. Average surgical time was 16 ± 2 minutes. &#x0D; Conclusion: Sutureless and glue-free limbal conjunctival autografting is a treatment modality for primary nasal pterygium with no additional cost and has only one recurrence case in 24 cases.

Comparative Assessment of Tear Function Tests, Tear Osmolarity, and Conjunctival Impression Cytology between Patients with Pterygium and Healthy Eyes.

Purpose:To compare histologic abnormalities of tear film and tear osmolarity between normal eyes and eyes with pterygium.Methods:This was a prospective, hospital-based, case–control study involving 95 patients (65 men, 30 women) with unilateral pterygium. The tear meniscus height (TMH), Schirmer's test-1 (SCH-1) score, Rose Bengal staining (RBS) score, tear film breakup time (TBUT), tear osmolarity (TO), and conjunctival impression cytology (CIC) were assessed in both eyes. The Chi-square and Student's t-tests were used to compare the results between the two groups. P values <0.05 were considered statistically significant.Results:The mean patient age was 50.9 years, with the largest age group being the 45–55 year-old bracket across both genders. Most patients (82.1%) had nasal pterygium, and 80% were involved in outside activities. The mean assessment values in the case and control groups were as follows: TMH, 0.21 vs. 0.24 mm; SCH-1, 13.2 vs. 17.8 mm; RBS, 4.38 vs. 2.51 points; TBUT, 8.7 vs. 13.2 seconds; TO, 306 vs. 299 mOsm/L (P < 0.001 in all cases). The proportions of abnormal assessment values in the case and control groups were as follows: TMH, 82.1% vs. 3.16%; SCH-1, 20% vs. 2.1%; RBS, 30.53% vs. 4.22%; TBUT, 61.05% vs. 6.3%; TO, 10.52% vs. 1.05%; CIC, 33.7% vs. 7.37% (P < 0.05 for all comparisons).Conclusion:This study showed that the quantity and quality of tear film, as well as the number of goblet cells, decreased, but the tear osmolarity increased in eyes with pterygium. Furthermore, the TMH, RBS results, TBUT, and CIC have more precise state of the patient's tear condition with the disease of the pterygium.

Autologous blood as tissue adhesive for conjunctival autograft in primary nasal pterygium surgery

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YKL-40 expression in pterygium: a potential role in the pathogenesis.

The aim of the study was to evaluate whether YKL-40 (chitinase 3-like 1 protein) plays a role in pterygium pathogenesis. We included 42 primary pterygium patients and 24 control subjects with normal bulbar conjunctiva in the study. The pterygium patients were classified into the atrophic, fleshy, and intermediate groups according to the Tan classification. We then surgically removed the primary nasal pterygium and normal bulbar conjunctiva from the patients and immunohistochemically investigated YKL-40 expression. YKL-40 expression was statistically significantly higher in the epithelial, endothelial, and stromal cells of the pterygium tissues than in the control tissues (P = 0.009, P = 0.003, P = 0.002, respectively). There was no significant correlation between the pterygium subgroups and YKL-40 expression (P > 0.05). We believe YKL-40 may play a significant role in pterygium pathogenesis.

Fibrin glue conjunctival autograft for primary pterygium: Overall outcomes and outcomes in expert versus trainee ophthalmologists

To determine outcomes of conjunctival autograft attached with fibrin glue (FG) for primary pterygium, and compare these outcomes in expert versus closely supervised trainee ophthalmologists. This was a retrospective, comparative, non-randomized, interventional study. Patients were recruited among those with primary nasal pterygium undergoing FG conjunctival autograft. Surgery was performed by expert (136 eyes) or closely supervised trainee (128 eyes) ophthalmologists. Mean follow-up was 7.82±8.23months. Main outcome measures were recurrence rate, reoperation rate and complications. The study sample comprised 264 eyes of 225 patients. Participants were of mean age 47.09±12.89years; 46.7% were male, 28.4% Caucasian and 70.5% Hispanic. Recurrence was recorded in 6.4%: 5.9% in the expert group and 7% in the trainee group (P=0.704) and reoperation in 1.9%: 0.7% and 3.1% (P=0.202), respectively. Both groups showed similar rates of complications such as transient graft edema, graft dehiscence, hematoma or ocular hypertension. Reoperation was slightly more frequent in patients younger than 40years (P=0.064). Good outcomes were observed for FG conjunctival autografting in primary pterygium surgery, with no differences recorded between supervised trainee and expert surgeons. Our findings suggest the need to supervise pterygium surgeries during training.