Abstract
Purpose Pterygium excision is often followed by recurrence that may be more severe than the initial lesion. This study evaluated the efficacy of conjunctival mini-autograft following surgical excision of pterygium.
Methods Eight patients underwent pterygium excision with a conjunctival mini-autograft. All patients had decreased visual acuity secondary to involvement of the central cornea by the pterygium. Following the excision, dissection of a conjunctival mini-autograft was performed. The mini-autograft was then transposed to the area of excision and secured in place with interrupted Vicryl and a few nylon sutures. Follow-up periods ranged from 5 to 9 years.
Results All eyes healed with no postoperative complications and no recurrences of the pterygium in any patient up to a maximum follow-up period of 9 years 10 months.
Conclusion Conjunctival mini-autograft with excision of the pterygium is an effective procedure for the surgical management of pterygium.
Similar content being viewed by others
Article PDF
References
Starck T, Hersh PS, Kenyon KR . Corneal dysgeneses, dystrophies, and degenerations. In: Albert DM, Jakobiec FA, editors. Principles and practice of ophthalmology. Philadelphia: WB Saunders, 1994:13–77.
Hilgers JHC . Pterygium. Its incidence, heredity and etiology. Am J Ophthalmol 1960;50:635–44.
Karai I, Horiguchi S . Pterygium in welders. Br J Ophthalmol 1984;68:347–9.
Taylor HR, West SK, Rosenthal FS, Munoz B, Newland HS, Emmett EA . Corneal changes associated with chronic UV irradiation. Arch Ophthalmol 1989;107:1481–4.
Ioachim-Velogianni E, Tsironi E, Agnantis N, Datseris G, Psilas K . HLA-DR antigen expression in pterygium epithelial cells and lymphocyte subpopulations: an immunochemistry study. Ger J Ophthalmol 1995;4:123–9.
Butrus SI, Ashraf MF, Laby DM, et al. Increased numbers of mast cells in pterygia. Am J Ophthalmol 1995;119:236–7.
Conlon MR, Alfonso EC, Starck T, Albert DM . Tumors of the cornea and conjunctiva. In: Albert DM, Jakobiec FA, editors. Principles and practice of ophthalmology. Philadelphia: WB Saunders, 1994:276–94.
Coroneo MT . Beheading the pterygium. Ophthalmic Surg 1992;23:691–2.
Walter WL . Another look at pterygium surgery with postoperative beta radiation. Ophthalmol Plast Reconstr Surg 1994;10:247–52.
Paryani SB, Scott WP, Wells JW Jr, et al. Management of pterygium with surgery and radiation therapy. Int J Radiat Oncol Biol Phys 1994;28:101–3.
Chapman-Smith JS . Pterygium treatment with triethylene thiophosphoramide. Aust N Z J Ophthalmol 1992;20:129–31.
Robert Y, Pauli L, Gysin P, Gloor B, Hendrickson P . Protracted ruthenium treatment of recurrent pterygium. Graefes Arch Clin Exp Ophthalmol 1992;230:233–6.
Cano-Parra J, Diaz-Llopis M, Maldonado MJ, Vila E, Menezo JL . Prospective trial of intraoperative mitomycin C in the treatment of primary pterygium. Br J Ophthalmol 1995;79:439–41.
Mastropasqua L, Carpineto P, Ciancaglini M, Lobefalo L, Gallenga PE . Effectiveness of intraoperative mitomycin C in the treatment of recurrent pterygium. Ophthalmologica 1994;208:247–9.
Fraudit-Pery J, Ilsar M, Hemo I . Single dosage of mitomycin C for prevention of recurrent pterygium: preliminary report. Cornea 1994;13:411–3.
Rachmiel R, Leiba H, Levartovsky S . Results of treatment with topical mitomycin C 0.02% following excision of primary pterygium. Br J Ophthalmol 1995;79:233–6.
Rosenthal G, Shoham A, Lifshitz T, Biedner B, Yassur Y . The use of mitomycin in primary pterygium. Ann Ophthalmol 1993;25:427–8.
Mahar PS, Nwokora GE . Role of mitomycin C in pterygium surgery. Br J Ophthalmol 1993;77:433–5.
Chayakul V . Postoperative mitomycin-C eye drop and beta radiation in the treatment of pterygia. J Med Assoc Thai 1991;74:373–6.
Guler M, Sobaci G, Ilker S, Ozturk F, et al. Limbal-conjunctival autograft transplantation in cases with recurrent pterygium. Acta Ophthalmol 1994;72:721–6.
Chen PP, Ariyasu RG, Kaza V, LaBree LD, McDonnell PJ . A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 1995;120:151–60.
Riordan EP, Kielhorn I, Ficker LA, Steele AD, Kirkness CM . Conjunctival autografting in the surgical management of pterygium. Eye 1993;7:634–8.
Allan BD, Short P, Crawford GJ, Barrett GD, Constable IJ . Pterygium excision with conjunctival autografting: an effective and safe technique. Br J Ophthalmol 1993;77:698–701.
Shaw EL . A modified technique for conjunctival transplant. CLAO J 1992;18:112–6.
McCoombes JA, Hirst LW, Isbell GP . Sliding conjunctival flap for the treatment of primary pterygium. Ophthalmology 1994;101:169–73.
Hara T, Shoji E, Hara T, Obara Y . Pterygium surgery using principle of contact inhibition and a limbal transplanted pedicle conjunctival strip. Ophthalmic Surg 1994;25:95–8.
Cohen RA, McDonald MB . Fixation of conjunctival autograft with an organic tissue adhesive. Arch Ophthalmol 1993;lll:1167–8.
Saifuddin S, Baum KL . Recurrent pterygia - laser therapy: a preliminary report. Indian J Ophthalmol 1993;41:17–9.
Suveges I . Sclerokeratoplasty in recurrent pterygium. Ger J Ophthalmol 1992;l:114–6.
Chau GK, Dilly SA, Sheard CE, Rostron CK . Deep lamellar keratoplasty on air with lyophilised tissue. Br J Ophthalmol 1992;76:646–50.
Krag S, Ehlers N . Excimer laser treatment of pterygium. Acta Ophthalmol 1992;70:530–3.
Haik G . The management of pterygium with particular reference to recurrent pterygia. South Med J 1952;45:832.
Jaros P, Deluise V . Pingueculae and pterygia. Surv Ophthalmol 1988;33:41–9.
Kenyon KR, Wagoner MD, Hettinger ME . Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 1985;92:1461–70.
Vastine DW, Stewart WB, Schwab IR . Reconstruction of the periocular mucous membrane by autologous conjunctival transplantation. Ophthalmology 1982;89:1071–81.
Eong KG, Tseng PS, Lim AS . Scierai necrosis and infection 15 years following pterygium excision. Singapore Med J 1995;36:232–4.
Sullivan LJ, Snibson G, Joseph C, Taylor HR . Scedosporium proliflcans sclerokeratitis. Aust N Z J Ophthalmol 1994;22:207–9.
Galanopoulos A, Snibson G, O'Day J . Necrotising anterior scleritis after pterygium surgery. Aust N Z J Ophthalmol 1994;22:167–73.
Levine DJ . Scierai complications following beta irradiation [letter, comment]. Arch Ophthalmol 1994;112:1016–7.
Fujitani A, Hayasaka S, Shibuya Y, Noda S . Corneoscleral ulceration and corneal perforation after pterygium excision and topical mitomycin C therapy. Ophthalmologica 1993;207:162–4.
Moriarty AP, Crawford GJ, McAllister IL, Constable IJ . Fungal corneoscleritis complicating beta-irradiation-induced scierai necrosis following pterygium excision. Eye 1993;7:525–8.
Edwin-Chow DA, Romanchuk KG, Gilmour GR, Underhill JH, Climenhaga DB . Corneal melting after pterygium removal followed by topical mitomycin C therapy. Can J Ophthalmol 1992;27:197–9.
Vrabec MP, Weisenthal RW, Elsing SH . Subconjunctival fibrosis after conjunctival autograft. Cornea 1993;12:181–3.
Rubinfeld RS, Pfister RR, Stein RM, et al. Serious complications of topical mitocyin-C after pterygium surgery. Ophthalmology 1992;99:1647–54.
Moriarty AP, Crawford GJ, McAllister IL, Constable IJ . Severe corneoscleral infection: a complication of beta irradiation scierai necrosis following pterygium excision. Arch Ophthalmol 1993;11:947–51.
Moriarty AP, Crawford GJ, McAllister IL, Constable IJ . Bilateral streptococcal corneoscleritis complicating beta irradiation induced scierai necrosis. Br J Ophthalmol 1993;77:251–2.
Prabhasawat P, Barton K, Burkett G, Tseng SC . Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104:974–85.
Ma DH, See LC, Liau SB, Tsai RJ . Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 2000;84:973–8.
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented at the annual meeting of the American Society of Cataract and Refractive Surgery, April 1996
Proprietary interest: None
Rights and permissions
About this article
Cite this article
John, T. Pterygium excision and conjunctival mini-autograft: Preliminary report. Eye 15, 292–296 (2001). https://doi.org/10.1038/eye.2001.97
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.2001.97
Keywords
This article is cited by
-
Optimal size of pterygium excision for limbal conjunctival autograft using fibrin glue in primary pterygia
BMC Ophthalmology (2018)
-
Mini-autograft for pterygium surgery
Eye (2002)
-
Pterygium excision and conjunctival mini-autograft
Eye (2002)