Primary Pterygium Surgery Research Articles

Suture Less and Glue-Free Inferior Limbal Conjunctival Autograft Transplantation in Primary Pterygium Surgery: A Case Series

Introduction: Conjunctival autografting which is the mainstay in the management of pterygium. The conjunctival graft is most commonly harvested superiorly. However, superior bulbar conjunctiva may not be available for harvesting a graft in all cases and it would affect the outcome. This study aims at the efficacy of the inferior bulbar conjunctival grafting without using any suture or glue. Methods: This was a prospective observational study conducted in the Department of Ophthalmology, Pabna Medical College Hospital, Pabna, Bangladesh during the period from January 2019 to December 2020. In our study, we included 100 eyes of 98 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 100 cases were included in this case series. Patient’s age ranged from 18 to 83 years (mean 48.08±12.76 years). Total graft dehiscence occurred in 2 eyes (2%), graft retraction in 10 eyes (10%), and recurrence was seen in 1 eye (1%). At 3 months postoperatively, the gain in uncorrected visual acuity ranged from 2-3 lines in the Snellen chart in 9 eyes, symblepharon does not occur in any patient and no other complication was noted. Conclusion: Our study shows that this simple technique for pterygium surgery may prevent the potential risk of bad outcomes of future filtration surgery and overcome the conditions when superior bulbar conjunctiva may not be available for harvesting a graft.

Comparison of Superior and Inferior Limbal Conjunctival Autograft Transplantation in Primary Pterygium Surgery: A Retrospective Analysis

Introduction: Conjunctival autografting is the cornerstone of pterygium treatment. The most typical way to harvest the conjunctival graft is superior. Nonetheless, it is not always possible to harvest a graft from the superior bulbar conjunctiva, which could impact the functionality and result of a subsequent filtering procedure [1]. This study aims to compare the effectiveness of superior conjunctival autografting and inferior conjunctival autografting without using glue or sutures. Methods: This was a prospective observational study conducted in the Department of Ophthalmology, Pabna Medical College Hospital, Pabna, Bangladesh during the period from January 2019 to December 2020. In our study, we included 200 eyes of 198 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 200 cases were included in this case series. 100 of them underwent superior limbal conjunctival autograft transplantation (Group A) and 100 of them underwent inferior limbal conjunctival autograft transplantation (Group B). There was one eye with recurrence in both groups, which was not statistically significant; there were two eyes with graft dehiscence in group B and one eye with graft dehiscence in group A. Graft retraction was not statistically significant in 12 cases in group A and 10 cases in group B. The inferior conjunctival autografting techniques are great alternatives with similar results and no increased risk of serious problems in cases where the superior conjunctiva must be maintained. Conclusion: Our findings show that suture-less and glue-free superior or inferior limbal conjunctival autograft is safe, cost-efficient, and successful.

Comparison of bare sclera combined with mitomycin c technique and limbal- conjunctival autograft technique in primary pterygium surgery

Comparison of bare sclera combined with mitomycin c technique and limbal- conjunctival autograft technique in primary pterygium surgery

Prospective Study: Utility of Anterior Segment Optical Coherence Tomography to Identify Predictive Factors of Recurrence in Pterygium Surgery.

Background/Objectives: The main purpose of this study is to determine, by anterior segment optical coherence tomography (AS-OCT), the anatomical characteristics, both preoperatively and postoperatively, that correlate with a higher rate of pterygium recurrence after surgery with exeresis and conjunctival autograft with biological glue. Methods: A total of 50 eyes which were listed for primary pterygium surgery at an ophthalmology tertiary centre were treated with standard pterygium excision and a conjunctival autograft with tissue glue. Ten variables were measured with AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan) during six control visits with all patients. Finally, statistical analysis was performed using SPSS (SPSS stadistics®, IBM®, version 21.0.0.0) for descriptive variables and R-project (The R foundation©, version 3.0.2) for the rest of the analyses, including a descriptive analysis and an inferential analysis studying prognostic factors of recurrence and their predictive capacity. Results: Among the 50 patients who underwent surgery, recurrence was detected in 8 cases (rate 16%; 95% CI: 5.8-26.2%). Most cases (n = 6) were detected 3 months after surgery. The pattern of recurrences was atrophic in two thirds of the cases; none required reintervention. Preoperative total conjunctival thickness at 3 mm was significantly increased in patients who developed recurrence. One week after surgery, epithelial and stromal thickness at 1 mm and total thickness at 3 mm proved to be useful for predicting recurrence. Both models have significant discriminant capacity. Conclusions: By imaging the graft with AS-OCT preoperatively and 7 days after surgery, the risk of future recurrence can be predicted.

Timing optimization for primary pterygium excision with conjunctival-limbal autograft to restore the corneal optical properties.

To propose the optimal value of baseline corneal astigmatism and pterygial morphological profiles for primary pterygium surgery to restore the corneal optical properties. We analysed 93 eyes from 84 subjects with nasal-only primary pterygium who underwent pterygium excision with conjunctival-limbal autograft and were assessed perioperatively using anterior segment swept-source optical coherence tomography (AS SS-OCT). We collected data on anterior corneal astigmatism (ACA) and root mean square (RMS) values for anterior corneal lower- (LoA) and higher-order aberrations (HoA) as corneal optical properties using AS SS-OCT. Using preoperative ACA and four pterygial morphological profiles (horizontal invasion length [HIL], height, thickness and the ratio of residual corneal thickness [RCT] to central corneal thickness [CCT]) measured in AS SS-OCT, we plotted receiver operating characteristic (ROC) curves. These curves aimed to determine cut-off values predicting a perioperative decrease exceeding 50% in ACA, RMS LoA and RMS HoA, as well as postoperative residual ACA higher than 1.25D. Preoperative ACA > 1.42D (AUC = 0.934) and >3.60D (AUC = 0.946) proved most effective in identifying subjects with perioperative decrease exceeding in ACA and RMS LoA, respectively. HIL > 3.34 mm (AUC = 0.941) was most effective in distinguishing subjects with perioperative reduction exceeding 50% in RMS HoA. Preoperative ACA > 5.78D (AUC = 0.776) and HIL > 5.03 mm (AUC = 0.700) significantly distinguished subjects with postoperative residual ACA higher than 1.25D. Optimizing the restoration of corneal astigmatism and aberrations after pterygium surgery may be facilitated by determining the optimal surgical timing based on preoperative ACA and HIL values.

Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis

BackgroundPterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis...

Efficiency of a Titanium-platelet Rich Fibrin Membrane in Primary Pterygium Surgery

Efficiency of a Titanium-platelet Rich Fibrin Membrane in Primary Pterygium Surgery

The Effect of Autografts from the Inferior and Superior Bulbar Conjunctiva on the Ocular Surface in Primary Pterygium Surgery: A Cytology Study.

This study aimed to evaluate the effect of using an inferior or superior conjunctival autograft in primary pterygium surgery on the postoperative ocular surface. Forty eyes of 40 patients who underwent pterygium surgery with autograft were included in the study. Cytological cell counts were performed on samples taken from the bulbar conjunctiva by impression cytology before and 1 year after the operation. Schirmer 1 test score, lissamine green conjunctival staining score, tear film break-up time (TBUT), and fluorescein corneal staining scores were evaluated. The pain levels of the patients were evaluated with visual analog scale at postoperative 1 day and 1 week. Corneal and conjunctival staining, TBUT, and Schirmer test results demonstrated significant improvement in all patient groups after surgery, but there was no difference between groups (p>0.05). In both preoperative and postoperative impression cytology, the number of goblet cells in the inferior bulbar conjunctiva was higher than in the superior bulbar conjunctiva (p<0.001), while there was no such difference in epithelial cell or mucin staining. There were no significant cytological changes postoperatively in either group (p>0.05). Pterygium surgery with autografting improved tear function tests regardless of graft location. Goblet cell count was higher in the inferior bulbar conjunctiva than in the superior bulbar conjunctiva in both postoperative and preoperative impression cytology. However, there was no significant difference in postoperative epithelial and goblet cell counts or mucin staining between the groups before and after surgery. We think that using the inferior bulbar conjunctiva is an appropriate choice in cases where the superior conjunctiva cannot be used as a graft or when future glaucoma surgery is possible.

Evaluating surgical outcome of pterygium excision with conjunctival autograft using autologous blood: Can it be a new norm?

To evaluate the surgical outcome of use of autologous blood as an adhesive agent in pterygium excision with conjunctival auto-grafting. To observe the effectiveness of autologous blood adherence on the scleral bed and to know whether autologous blood technique can be made as a standard procedure in pterygium surgery or not.The present study is a retrospective observational study. The records of 94 cases of primary pterygium surgery done during August 2022- January 2023 were taken. All patients underwent comprehensive ocular examination pertinent to the disease. Pterygium was dissected and remaining subconjunctival pterygium tissue was separated and excised. The conjunctival limbal auto-graft was taken secured in place by autologous blood and dressing done. Follow-up was done on second post operative day,1st week and 1 month. The study displayed excellent surgical outcome with minimal post operative complications, which too resolved in a week. The most common complication was subconjunctival hemorrhage in 38 cases followed by graft edema in 32 cases. Though graft displacement was observed in 4 cases, they were later rearranged successfully. We did not observe even a single graft loss in our study.Pterygium excision with conjunctival auto-grafting with autologous blood is very safe, less time consuming, easy to perform with less learning curve, economical with excellent postoperative outcome and most importantly more patient satisfaction, thus, making it equivalent to or rather superior to other comparable procedures.

Pilot Study of Seamless Diplen Membrane for Pterygium Excision

We report a technique of fixation of rotational flap of the conjunctiva in primary surgical treatment of pterygium using a biodegradable adhesive Diplen membrane. A 78 years old patient was referred to ophthalmology department of «……………..» in September 2022 for treatment of pterygium of right eye. Primary pterygium surgery was performed using fixed rotational flap of the conjunctiva. In this method, the conjunctival flap is rotated to close the open sclera and fixed with a biodegradable adhesive Diplen membrane.The flap did not undergo ischemic changes, retained its original position and fully took root. Inflammatory and allergic reactions to the components of the membrane were not observed. Seamless fixation of conjunctival flap using an adhesive Diplen membrane is a safe, cost-effective and reliable method of treating pterygium.

Effects of Subconjunctival Bevacizumab Injection after Primary Pterygium Surgery

Purpose: This study evaluated the efficacy and safety of subconjunctival bevacizumab injection after primary pterygium surgery.Methods: We performed a conjunctivo-limbal autograft after pterygium resection in 136 eyes of 128 patients with primary pterygium between December 2019 and July 2021. A subconjunctival bevacizumab injection of 2.5 mg (0.1 mL) was administered in the bevacizumab group but not in the control group (54 eyes of 48 patients). We compared pterygium recurrence rates between the two groups at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after surgery.Results: Pterygium recurrence occurred in one eye (1.21%) in the bevacizumab group and five eyes (9.25%) in the control group. Additionally, fibrovascular tissue proliferation was suppressed in the bevacizumab group and no postoperative complications were observed.Conclusions: Pterygium recurrence occurred in one eye (1.21%) in the bevacizumab group and five eyes (9.25%) in the control group. Additionally, fibrovascular tissue proliferation was suppressed in the bevacizumab group and no postoperative complications were observed.

Outcomes of Fibrin Glue for Graft Fixation in Primary Pterygium Surgery with Conjunctival Autograft

Objective: To evaluate the recurrence rate and postoperative complications of fibrin glue fixation of conjunctival autografts following primary nasal pterygium excision. Materials and Methods: The present study was a retrospective study of all eyes with primary nasal pterygium that underwent pterygium excision with conjunctival autograft transplantation using fibrin glue for graft fixation at Mettapracharak (Wat Rai Khing) Hospital between July 2017 and December 2018. The author analyzed pterygium recurrence rates and postoperative complications such as graft loss, graft displacement or dehiscence, pyogenic granuloma, or any other complications. Results: Fifty-seven eyes of 57 patients were evaluated, of which 43 (75.4%) were female. The mean age was 57.09±1.38 years (range of 34 to 80 years). No serious complications occurred. One eye (1.8%) sustained recurrence in the six months follow-up. All grafts were intact. Graft displacement requiring suturing occurred in three cases (5%). Graft dehiscence was observed in 29.8%, and in all cases epithelialized without intervention. Other postoperative complications included pyogenic granuloma in 3.5%, graft edema, subgraft hemorrhage in 21.1%, and elevation of intraocular pressure over 21 mmHg in 5.3%. Conclusion: Fibrin glue for fixation for conjunctival autografts after primary nasal pterygium excision is safe and effective. The most common complication in the present study was graft dehiscence, which did not require surgical intervention. Keywords: Conjunctival autograft; Fibrin glue; Pterygium recurrence rate; Graft dehiscence

Conjunctival and Limbal Conjunctival Autograft vs. Amniotic Membrane Graft in Primary Pterygium Surgery: A 30-Year Comprehensive Review.

The purpose of this study is to compare the "real-life" effectiveness of amniotic membrane graft (AMG) and conjunctival (CAT) or limbal conjunctival (LCA) autograft in the management of primary pterygium. Human-based studies on primary pterygium surgery that were published between 1993 and 2022 with at least 3months of follow-up were identified, and only those that were retrospective were included. The global recurrence rate of pterygium was assessed for each surgical technique separately. Specific recurrence rates taking into consideration the fixation technique (glue versus sutures) were also measured. 35 real-life retrospective subgroups comprising a total of 3747 eyes were included in the final review. The mean global recurrence rates for CAT, LCA and AMG were 7.61%, 5.50% and 9.0%, respectively. Recurrences were less common for patients who received fibrin glue (5.92%, 2.56% and 3.60%) than for those who received sutures (8.99%, 6.03% and 23.0%) for the three groups, respectively. Surgical techniques combining CAT or LCA with AMG yielded an even lower global recurrence rate (1.83%). AMG seems like a reasonable option that could be considered in primary pterygium surgery, especially when glued to the underlying sclera. Combining AMG with other treatment modalities such as CAT or LCA seems to offer an interesting alternative in terms of recurrence.

Cauterized conjunctival autograft with and without mitomycin C in primary pterygium surgery

Aim To compare between the outcomes of cauterized conjunctival autograft (CA) with and without mitomycin C (MMC) in primary pterygium surgery. Patients and methods This prospective interventional comparative study included 50 eyes in 50 patients with primary pterygium. Patients were randomly assigned into two equal groups: group 1 underwent pterygium excision with cauterized CA fixation, and group 2 underwent pterygium excision with cauterized CA fixation and intraoperative application of 0.02% MMC for 3 min. All patients underwent a preoperative, first day, first week, first month, third month, and sixth month postoperative ophthalmic examination. Any intraoperative or postoperative complications were recorded. Primary outcomes were reported as incidence of recurrence and any major (sight threatening) complications. Secondary outcomes were reported as any minor complications. Results A total of 50 patients (28 males and 22 females, with male to female ratio 1 : 1.3) were included in this study. Complications encountered in our study included recurrence of pterygium, which occurred in one (4%) eye in group 1 and 0 eyes in group 2. Two (8%) eyes in group 1 versus one (4%) eye in group 2 showed subconjunctival hemorrhage, one (4%) eye in group 2 showed focal scleral thinning, and one (4%) eye in group 2 showed a corneal epithelial defect. There was no statistically significant difference between the two groups regarding the incidence of any complication (P&gt;0.05). Conclusion Cauterized CA without MMC is a safe and effective procedure for the surgical treatment of primary pterygium. There was no added benefit to intraoperative MMC application.

Autologous Serum for Fixation of Limbal Conjunctival Autograft in Primary Pterygium Surgery

Purpose: To find out the efficacy and structural stability of autologous serum for the fixation of limbal conjunctival Autograft in the management of pterygium surgery. Study Design: Quasi-experimental study. Place and Duration of Study: Orbit and Oculoplastic department of LRBT Hospital, Karachi, from June 2020 to November 2020. Methods: This study included 100 eyes of 100 patients with primary pterygium.Eyes with nasal Pterygium of grade III were included. Patients with ocular surface disorders, infection, inflammation, pseudo pterygium, pterygium at temporal side and coagulation disorders were excluded. After pterygium excision, a free limbal conjunctival Autograft was taken from superotemporal quadrant of bulbar conjunctiva of same eye and was used to cover the bare sclera with autologous serum. Subconjunctival injection of antibiotic and steroid was given followed by 24 hour of eye pad. Postoperative outcomes of the graft were noted at theend of the six months period of follow up. Results: The mean age of the patients was 46.5 ± 8.97 years (range 20 – 60 years). Male to female ratio was 3:1 (75 males and 25 females). Graft loss was found in five patients, graft edema in one patient, graft retraction in three patients, graft overriding in two patients, recurrence of pterygium in six patients, granuloma in two patients and subconjunctival hemorrhage in 10 patients. Conclusion: Autologous serum for fixation of limbal conjunctival Autograft is a safe, efficient and cost-effective method of treatment for primary pterygium surgery.

Corneal morphological and structural changes measured with pentacam induced by pterygium surgery

AbstractIntroduction: Pterygium has been related to the induction of astigmatic and optical aberrations and surgery could induce a reduction in these corneal characteristics.Purpose: Study main objective was to evaluate corneal changes and optical aberrations that occura after primary pterygium surgery, and as a secondary objective, to evaluate changes depending on the used surgical technique (simple excision vs. conjunctival plasty).Methods: Data collection was performed through Scheimpflug camera system for anterior segment analysis (Pentacam®): corneal astigmatism in diopters (K) and curvature radius and corneal aberration (Root Mean Square (RMS) Low order aberrations (LOA) and RMS High Order aberrations HOA) in a total of 18 eyes of 18 patients from the Hospital Universitario de Jerez (HUJ) who need pterigion surgery. Variables measured were analysed before surgery and 3 months later.Results: Results showed that there is no statistically significant change in astigmatism after pterygium surgery, although there is a statistically significant reduction in total RMS of the anterior cornea (p = 0.02), RMS LOA of the anterior cornea (p = 0.03) and RMS HOA of total cornea (p = 0.007), anterior cornea (p = 0.03) and posterior cornea (p = 0.03). There are not statistically significant differences between both groups when comparing the surgical technique used.Conclusions: No statistically significant changes in astigmatism after pterygium surgery have been found, but there is a significant decrease in optical aberrations, especially in the anterior cornea. It cannot be concluded that one surgical technique is superior to another.

Cases of toxic anterior segment syndrome after primary pterygium surgery.

Toxic anterior segment syndrome (TASS) is an acute, sterile,inflammatory reaction of the anterior segment afterintraocularsurgeries. We aimed to report an outbreak of TASS which occurred following pterygium surgeries. A case series. Four eyes of four patients developed TASS associated with formaldehyde after uneventful primary pterygium surgery with conjunctival autograft. No patients reported pain; all patients demonstrated diffuse corneal edema, epithelial defects, and anterior chamber inflammation without hypopyon, fibrin formation, and vitreous involvement on the first postoperative day. TASS diagnosis was made based on clinical findings. All patients were treated with hourly topical 1% prednisolone acetate (Pred Forte, Allergan, CA), moxifloxacin 0.5% (Vigamox, Alcon, TX), and 0.24% of hyaluronic acid (Artelac complete, Bausch & Lomb). Oral steroid (prednisolone 1mg/kg) was added on the first week and gradually tapered over weeks. None of the affected corneas improved spontaneously. Best-corrected visual acuity ranged from 20/25000 to 20/200 in the second month after surgery. Keratoplasty wasscheduled for all patients. This is the first study to present TASS cases after pterygium surgery. Clinicians should be aware of TASS that can emerge after an extraocular surgery. In our analysis, since 2% formaldehyde was used by the operating room personnel for cleaning and sterilizing reusable ocular instruments, it was thought that formaldehyde was the most likely cause.

Efficacy of Autologous Blood Clot in Primary Pterygium Surgery Compared With Suture Technique in a Tertiary Hospital of Bangladesh

Purpose: The aim of this study is to assess the efficacy among patients undergoing pterygium excision and conjunctival autograft utilizing autologous blood or sutures. Methods: A randomized controlled trial of 1 year and 5 months, with 60 eyes from 60 patients having primary nasal pterygium. As indicated by inclusion criteria, they were chosen and randomized into two arms for conjunctival autograft: treated arm A (30) with autologous blood and arm B (30) with stitches (10-0 monofilament nylon). Preoperative and postoperative results were assessed and analyzed statistically. Follow-up was done at first, seventh, 1-month, 3-month, and half-year postoperative days. Resulting factors were total surgical time, postoperative comfort, graft stability, and recurrence. Results: 60 patients; mean age of 46.77 ± 7.04 (SD) in arm A (30) and 46.17±7.53 (SD) in arm B (30). In arm A, 22 males (73.3%) and 8 females (26.7%) where arm B had 20 males (66.7%) and 10 females (33.3%). Total surgical time in arm A was 24.73 ± 3.69 (SD) minutes and in arm B was 32.23 ± 4.59 (SD) minutes (p &lt; 0.001). Follow-up at the 1st and 7th POD showed significant discomfort in arm B (mean ranks 41.82 and 40.62) compared to arm A (mean ranks 19.18 and 20.38), respectively (p &lt; 0.001). At 1st POD, only 3 (10%) graft retractions in arm A. Within 6 months of follow-up, all grafts were stable; 1 (3.3%) recurrence and 1 (3.3%) granuloma in arm B only. Conclusion: In primary pterygium surgery, autologous blood showed excellent postoperative results with no recurrence and reduced surgical time. So, it seems to be an effective surgical means to treat primary pterygium.

Efficacy of Autologous Blood Clot in Primary Pterygium Surgery Compared With Suture Technique in a Tertiary Hospital of Bangladesh

Purpose: The aim of this study is to assess the efficacy among patients undergoing pterygium excision and conjunctival autograft utilizing autologous blood or sutures. Methods: A randomized controlled trial of 1 year and 5 months, with 60 eyes from 60 patients having primary nasal pterygium. As indicated by inclusion criteria, they were chosen and randomized into two arms for conjunctival autograft: treated arm A (30) with autologous blood and arm B (30) with stitches (10-0 monofilament nylon). Preoperative and postoperative results were assessed and analyzed statistically. Follow-up was done at first, seventh, 1-month, 3-month, and half-year postoperative days. Resulting factors were total surgical time, postoperative comfort, graft stability, and recurrence. Results: 60 patients; mean age of 46.77 ± 7.04 (SD) in arm A (30) and 46.17±7.53 (SD) in arm B (30). In arm A, 22 males (73.3%) and 8 females (26.7%) where arm B had 20 males (66.7%) and 10 females (33.3%). Total surgical time in arm A was 24.73 ± 3.69 (SD) minutes and in arm B was 32.23 ± 4.59 (SD) minutes (p &lt; 0.001). Follow-up at the 1st and 7th POD showed significant discomfort in arm B (mean ranks 41.82 and 40.62) compared to arm A (mean ranks 19.18 and 20.38), respectively (p &lt; 0.001). At 1st POD, only 3 (10%) graft retractions in arm A. Within 6 months of follow-up, all grafts were stable; 1 (3.3%) recurrence and 1 (3.3%) granuloma in arm B only. Conclusion: In primary pterygium surgery, autologous blood showed excellent postoperative results with no recurrence and reduced surgical time. So, it seems to be an effective surgical means to treat primary pterygium.

Primary Pterygium Surgery: An Alternative Method Utilizing Conjunctival Tissue Over Thepterygium Itself Retaining its Own Vascular Supply

ntroduction: The gold standard management of pterygium is pterygium excision with conjunctival autograft utilizing the superior bulbar conjunctiva, but its preservation is essential for future glaucoma surgery. Aim/Objective: The aim of this study is to find out the outcome and complications of primary pterygium excision utilising the conjunctival tissue over the pterygium itself to cover the bare area retaining its own vascular supply and to preserve the superior bulbar conjunctiva for future uses. Materials and Methods: In this retrospective non-comparative study, 42 eyes with primary pterygium underwent pterygium excision utilising conjunctival tissue over the pterygium itself maintaining its original position and retaining its vascular supply for the period of 2018-2020. Methodology: In this technique two conjunctival incisions were given, one at the neck of the pterygium and other at 5-5.5 mm away from the limbus. The underlying fibrovascular tissue was separated and removed. Conjunctival tissue was placed in its normal position over the bare sclera maintaining its own vascular supply. Results: Mean age of the study population was 44.86 ± 11.68 years. Mean follow-up period was 12.62 ± 3.96 months. No recurrence was detected in the follow-up periods. The main two complications were subconjunctival injection and graft edema which were 100% and 33.33% respectively. Conclusion: This study results provide that utilization of the conjunctival tissue over the pterygium itself with retaining its own vascular supply can be a useful alternative technique for the management of primary pterygium and thus the superior bulbar conjunctiva can be preserved for future uses.