Acquired melanosis of a conjunctival autograft following pterygium surgery

Pterygium excision with conjunctival autografting is an established surgical treatment for symptomatic pterygia. Documented complications include wound dehiscence, Tenon's granuloma, inclusion cysts, graft oedema, and corneoscleral dellen. We illustrate a previously unreported complication of this technique. A 41 year old Sri Lankan man presented with selective hyperpigmentation of the conjunctival autograft approximately three months following pterygium excision. The possible biological mechanisms behind this complication are discussed.