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Double-head pterygium excision with modified vertically split-conjunctival autograft: Six-year long-term
Shreesha Kumar Kodavoor1, Dandapani Ramamurthy2, Nitin Narendra Tiwari2
1Department of Cornea and Refractive Services, The Eye Foundation, Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India.
Indian Journal of Ophthalmology
|August 19, 2017
Summary
This study presents a modified conjunctival autograft (CAG) technique for double-head pterygium, showing a low recurrence rate. The vertical split CAG method offers a successful surgical option for this common eye condition.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Corneal Diseases
Background:
- Pterygium, particularly double-head pterygium, is a common ocular surface condition.
- Surgical intervention is often required for symptomatic or visually significant pterygia.
- Conjunctival autograft (CAG) is a standard surgical approach, but modifications aim to improve outcomes.
Purpose of the Study:
- To describe a modified vertically split conjunctival autograft (CAG) technique for primary double-head pterygium.
- To evaluate the postoperative outcomes of this modified CAG technique.
Main Methods:
- A retrospective case series included 87 eyes with double-head pterygium.
- Patients underwent a modified vertical split CAG procedure, not strictly maintaining limbus-limbus orientation.
- Recurrence rate was the primary outcome; graft retraction, granuloma, and dellen were secondary outcomes.
Main Results:
- The recurrence rate was low at 3.45% (3 out of 87 eyes).
- Graft edema was the most common secondary outcome (42.52%), resolving spontaneously.
- Other recorded outcomes included graft retraction (31.03%), Tenon's granuloma (3.45%), and subconjunctival hemorrhage (36.78%).
Conclusions:
- The modified vertical split CAG technique is effective for treating double-head pterygium.
- This approach demonstrates a low recurrence rate.
- The technique is successful without strict limbus-limbus orientation, covering only the bare scleral defect.