Double-head pterygium excision with modified vertically split-conjunctival autograft: Six-year long-term retrospective analysis

• Main Authors: Shreesha Kumar Kodavoor, Dandapani Ramamurthy, Nitin Narendra Tiwari, Shreyas Ramamurthy
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Double-head pterygium; pterygium recurrence; vertical split conjunctiva; without limbus-limbus
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2017;volume=65;issue=8;spage=700;epage=704;aulast=Kodavoor
• ISSN: 0301-4738; 1998-3689

Purpose: The aim of this study is to describe a modified technique of vertically split-conjunctival autograft (CAG) for primary double-head pterygium and evaluate its postoperative outcome. Methods: In this retrospective, noncomparative, interventional case series, 87 eyes of 87 patients of double-head pterygium from June 2009 to June 2015 were included. They underwent vertical split CAG. A limbus-limbus orientation was not strictly maintained. Primary outcome measure was recurrence rate. Other outcome measures studied were graft retraction, Tenon's granuloma, dellen, and so on. Results: Mean age was 54.54 ± 11.51 years; M:F was 41:46. Mean follow-up was 17.28 ± 10.28 months. The only significant complication was recurrence rate of 3.45% (3 eyes out of 87). Other most common secondary outcome was graft edema, 42.52% (37 eyes out of 87) which resolved without any intervention. Other outcomes such as graft retraction (31.03%), dellen (1.15%), Tenon's granuloma (3.45%), and subconjunctival hemorrhage (36.78%) were recorded. Conclusion: Modified vertical split CAG without maintaining limbus-limbus orientation, just large enough to cover the bare scleral defect, appears to be a successful technique with lower recurrence rate in treating double-head pterygium.