Conjunctival Rotation Autograft for Pterygium: An Alternative to Conventional Conjunctival Autografting

To determine the safety and efficacy of conjunctival rotation autograft (CRA) as an alternative to conventional conjunctival autograft after pterygium excision and its complications and rate of recurrence.

A prospective non-comparative interventional case study.

Conjunctival rotation autograft was performed under peribulbar block in 50 eyes with primary pterygium as well as recurrent pterygium of grade 1, 2 and 3 according to a morphological grading system. Patients were followed up for 12 months for complications like graft retraction, injection, recurrence, etc.

A total of 55 CRAs were done in 50 eyes of 47 subjects in the study wherein grafts were attached by using the 10-0 nylon sutures in primary and recurrent pterygia. Mean follow up period was 11.67 months (Range 9-12 months). The most commonly found complications were graft injection in 16 (29.09%) cases and graft pigmentation in 5 (9.0%) cases. Injection was not associated with pterygium grade and was found to be statistically insignificant (P = 0.27). Recurrence was found only in 1 (1.8%) case in grade T3 recurrent pterygium.

Conjunctival rotation autograft appears to be a successful and safe alternative to conjunctival autograft, with a relatively low rate of pterygium recurrence in this uncontrolled series. We advocate the use of CRA for cases of pterygium in which a conventional autograft is contraindicated or difficult. In addition, the procedure can be used as a primary surgical option in primary and recurrent pterygia.